Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	26	$275.42	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $575.44 / $1,548.82	Professional		$346.74	$575.44	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $354.81	Professional	26	$85.11	$123.03	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $416.87 / $1,174.90	Professional	TC	$257.04	$416.87	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,148.15 / $1,258.93	Professional		$1,122.02	$1,148.15	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $316.23 / $354.81	Professional	26	$165.96	$316.23	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $831.76 / $977.24	Professional	TC	$794.33	$831.76	$977.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $954.99 / $2,137.96	Professional		$812.83	$954.99	$2,137.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $251.19 / $524.81	Professional	26	$208.93	$251.19	$524.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $691.83 / $1,318.26	Professional	TC	$575.44	$691.83	$1,318.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,479.11 / $2,454.71	Professional		$1,288.25	$1,479.11	$2,454.71
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $346.74 / $575.44	Professional	26	$316.23	$346.74	$575.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $1,122.02 / $1,862.09	Professional	TC	$954.99	$1,122.02	$1,862.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,148.15	Professional		$602.56	$870.96	$1,148.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $275.42 / $338.84	Professional	26	$72.44	$275.42	$338.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $794.33 / $977.24	Professional	TC	$281.84	$794.33	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $954.99 / $1,905.46	Professional		$891.25	$954.99	$1,905.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $257.04 / $501.19	Professional	26	$218.78	$257.04	$501.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $707.95 / $1,513.56	Professional	TC	$676.08	$707.95	$1,513.56