Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $264.55 / $599.91 / $1,107.90	Facility	26	$264.55	$599.91	$1,107.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.50 / $275.76 / $772.27	Professional		$193.50	$275.76	$772.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.87 / $110.60 / $368.13	Professional	26	$72.87	$110.60	$368.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.64 / $150.21 / $385.40	Professional	TC	$120.64	$150.21	$385.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.94 / $623.75 / $669.91	Professional		$280.94	$623.75	$669.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.12 / $266.45 / $305.41	Professional	26	$124.12	$266.45	$305.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.82 / $318.33 / $386.65	Professional	TC	$156.82	$318.33	$386.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $452.05 / $554.54 / $1,439.04	Professional		$452.05	$554.54	$1,439.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $198.13 / $242.98 / $598.40	Professional	26	$198.13	$242.98	$598.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $235.38 / $304.70 / $619.25	Professional	TC	$235.38	$304.70	$619.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $698.75 / $760.05 / $1,258.31	Professional		$698.75	$760.05	$1,258.31
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $306.25 / $330.75 / $552.04	Professional	26	$306.25	$330.75	$552.04
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $392.50 / $430.65 / $706.26	Professional	TC	$392.50	$430.65	$706.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $270.08 / $703.75 / $1,192.80	Professional		$270.08	$703.75	$1,192.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $266.45 / $370.50 / $552.04	Professional	26	$266.45	$370.50	$552.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $369.89 / $474.00 / $706.26	Professional	TC	$369.89	$474.00	$706.26
United Facility/Professional Professional Modifier Low / Median / High Price $344.51 / $748.50 / $1,192.60	Professional		$344.51	$748.50	$1,192.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.13 / $366.48 / $583.91	Professional	26	$132.13	$366.48	$583.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.42 / $382.02 / $608.69	Professional	TC	$220.42	$382.02	$608.69