Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $457.09 / $1,258.93	Facility	26	$331.13	$457.09	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $489.78 / $1,621.81	Professional		$371.54	$489.78	$1,621.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $416.87	Professional	26	$85.11	$131.83	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $354.81 / $1,047.13	Professional	TC	$275.42	$354.81	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,230.27 / $1,412.54	Professional		$912.01	$1,230.27	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $295.12 / $380.19	Professional	26	$204.17	$295.12	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $831.76 / $1,047.13	Professional	TC	$645.65	$831.76	$1,047.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $457.09 / $1,258.93	Facility	26	$380.19	$457.09	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,023.29 / $1,949.84	Professional		$602.56	$1,023.29	$1,949.84
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $302.00 / $575.44	Professional	26	$138.04	$302.00	$575.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $741.31 / $1,202.26	Professional	TC	$446.68	$741.31	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,584.89 / $2,454.71	Professional		$1,412.54	$1,584.89	$2,454.71
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $416.87 / $691.83	Professional	26	$389.05	$416.87	$691.83
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,023.29 / $1,174.90 / $1,778.28	Professional	TC	$1,023.29	$1,174.90	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $912.01 / $1,174.90	Professional		$524.81	$912.01	$1,174.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $275.42 / $380.19	Professional	26	$87.10	$275.42	$380.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $676.08 / $1,000.00	Professional	TC	$269.15	$676.08	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,412.54 / $3,467.37	Professional		$870.96	$1,412.54	$3,467.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $457.09 / $1,122.02	Professional	26	$263.03	$457.09	$1,122.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $954.99 / $2,344.23	Professional	TC	$676.08	$954.99	$2,344.23