Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $267.11 / $267.11 / $267.11	Facility	26	$267.11	$267.11	$267.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $576.96 / $1,839.35	Professional		$475.00	$576.96	$1,839.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.28 / $140.00 / $523.62	Professional	26	$131.28	$140.00	$523.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $445.68 / $1,315.73	Professional	TC	$335.00	$445.68	$1,315.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.11 / $1,125.00 / $1,257.79	Professional		$514.11	$1,125.00	$1,257.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.49 / $291.35 / $337.50	Professional	26	$129.49	$291.35	$337.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $384.62 / $787.50 / $966.44	Professional	TC	$384.62	$787.50	$966.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $818.85 / $994.65 / $2,141.92	Professional		$818.85	$994.65	$2,141.92
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $205.40 / $251.78 / $619.14	Professional	26	$205.40	$251.78	$619.14
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $578.26 / $748.17 / $1,522.79	Professional	TC	$578.26	$748.17	$1,522.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,281.25 / $1,472.90 / $2,431.67	Professional		$1,281.25	$1,472.90	$2,431.67
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $317.50 / $342.90 / $569.92	Professional	26	$317.50	$342.90	$569.92
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $963.75 / $1,117.95 / $1,861.76	Professional	TC	$963.75	$1,117.95	$1,861.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $475.08 / $1,295.00 / $2,385.60	Professional		$475.08	$1,295.00	$2,385.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $276.86 / $382.50 / $569.92	Professional	26	$276.86	$382.50	$569.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $839.01 / $1,249.50 / $1,861.76	Professional	TC	$839.01	$1,249.50	$1,861.76
United Facility/Professional Professional Modifier Low / Median / High Price $835.17 / $1,155.25 / $2,461.92	Professional		$835.17	$1,155.25	$2,461.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.22 / $263.20 / $673.90	Professional	26	$124.22	$263.20	$673.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $671.21 / $707.14 / $1,788.03	Professional	TC	$671.21	$707.14	$1,788.03