Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $324.57 / $577.28 / $1,269.67	Facility	26	$324.57	$577.28	$1,269.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.36 / $596.01 / $1,639.71	Professional		$512.36	$596.01	$1,639.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.25 / $145.94 / $461.83	Professional	26	$91.25	$145.94	$461.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $421.11 / $492.70 / $1,053.74	Professional	TC	$421.11	$492.70	$1,053.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $580.78 / $973.00 / $1,421.55	Professional		$580.78	$973.00	$1,421.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.44 / $276.00 / $355.00	Professional	26	$158.44	$276.00	$355.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $422.35 / $681.10 / $1,066.55	Professional	TC	$422.35	$681.10	$1,066.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $928.13 / $1,122.75 / $2,431.66	Professional		$928.13	$1,122.75	$2,431.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $250.68 / $306.36 / $753.12	Professional	26	$250.68	$306.36	$753.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $635.39 / $821.91 / $1,678.55	Professional	TC	$635.39	$821.91	$1,678.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,427.40 / $1,580.85 / $2,547.90	Professional		$1,427.40	$1,580.85	$2,547.90
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $387.50 / $434.00 / $697.50	Professional	26	$387.50	$434.00	$697.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,020.50 / $1,166.40 / $1,855.05	Professional	TC	$1,020.50	$1,166.40	$1,855.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $539.34 / $1,423.20 / $2,305.80	Professional		$539.34	$1,423.20	$2,305.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $291.89 / $465.00 / $692.85	Professional	26	$291.89	$465.00	$692.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $835.99 / $1,245.00 / $1,855.05	Professional	TC	$835.99	$1,245.00	$1,855.05
United Facility/Professional Professional Modifier Low / Median / High Price $916.68 / $993.07 / $3,453.00	Professional		$916.68	$993.07	$3,453.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $153.94 / $460.77 / $1,125.00	Professional	26	$153.94	$460.77	$1,125.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $668.79 / $949.74 / $2,328.00	Professional	TC	$668.79	$949.74	$2,328.00