Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $207.09 / $368.35 / $470.90	Facility	26	$207.09	$368.35	$470.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.58 / $451.73 / $1,141.09	Professional		$366.58	$451.73	$1,141.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $74.53 / $331.51	Professional	26	$60.39	$74.53	$331.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.18 / $381.20 / $640.65	Professional	TC	$306.18	$381.20	$640.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $394.40 / $920.00 / $991.00	Professional		$394.40	$920.00	$991.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.10 / $228.56 / $276.00	Professional	26	$99.10	$228.56	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.31 / $644.00 / $762.45	Professional	TC	$295.31	$644.00	$762.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $631.24 / $765.63 / $1,668.81	Professional		$631.24	$765.63	$1,668.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.50 / $194.76 / $481.03	Professional	26	$158.50	$194.76	$481.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $445.14 / $575.42 / $1,187.73	Professional	TC	$445.14	$575.42	$1,187.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $952.50 / $1,089.45 / $1,754.48	Professional		$952.50	$1,089.45	$1,754.48
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $245.00 / $264.60 / $444.77	Professional	26	$245.00	$264.60	$444.77
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $703.75 / $824.85 / $1,309.71	Professional	TC	$703.75	$824.85	$1,309.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $370.14 / $973.00 / $1,605.91	Professional		$370.14	$973.00	$1,605.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $214.63 / $298.50 / $444.77	Professional	26	$214.63	$298.50	$444.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $644.00 / $879.00 / $1,292.33	Professional	TC	$644.00	$879.00	$1,292.33
United Facility/Professional Professional Modifier Low / Median / High Price $633.50 / $1,003.14 / $1,598.34	Professional		$633.50	$1,003.14	$1,598.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.91 / $294.81 / $469.73	Professional	26	$93.91	$294.81	$469.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $436.40 / $654.60 / $1,128.60	Professional	TC	$436.40	$654.60	$1,128.60