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 / $575.44	Facility	26	$275.42	$275.42	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $1,023.29	Professional		$257.04	$363.08	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $102.33 / $354.81	Professional	26	$83.18	$102.33	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $245.47 / $630.96	Professional	TC	$169.82	$245.47	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $977.24 / $1,148.15	Professional		$912.01	$977.24	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $288.40 / $316.23	Professional	26	$165.96	$288.40	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $676.08 / $831.76	Professional	TC	$645.65	$676.08	$831.76
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	26	$575.44	$575.44	$575.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $870.96 / $1,548.82	Professional		$501.19	$870.96	$1,548.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $251.19 / $501.19	Professional	26	$138.04	$251.19	$501.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $588.84 / $851.14	Professional	TC	$363.08	$588.84	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,258.93 / $1,949.84	Professional		$1,096.48	$1,258.93	$1,949.84
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $346.74 / $575.44	Professional	26	$323.59	$346.74	$575.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $933.25 / $1,380.38	Professional	TC	$794.33	$933.25	$1,380.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $776.25 / $977.24	Professional		$416.87	$776.25	$977.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $275.42 / $316.23	Professional	26	$72.44	$275.42	$316.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $660.69 / $794.33	Professional	TC	$208.93	$660.69	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,454.71	Professional		$776.25	$1,122.02	$2,454.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $380.19 / $831.76	Professional	26	$218.78	$380.19	$831.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $741.31 / $1,819.70	Professional	TC	$524.81	$741.31	$1,819.70