Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $297.48 / $529.12 / $922.96	Facility	26	$297.48	$529.12	$922.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $388.85 / $477.43 / $1,527.62	Professional		$388.85	$477.43	$1,527.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $131.05 / $423.30	Professional	26	$84.53	$131.05	$423.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.31 / $378.88 / $941.65	Professional	TC	$304.31	$378.88	$941.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $515.47 / $973.00 / $1,285.77	Professional		$515.47	$973.00	$1,285.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.74 / $276.00 / $326.72	Professional	26	$143.74	$276.00	$326.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.73 / $681.10 / $959.05	Professional	TC	$371.73	$681.10	$959.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $827.73 / $998.55 / $2,180.48	Professional		$827.73	$998.55	$2,180.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $228.85 / $280.37 / $689.92	Professional	26	$228.85	$280.37	$689.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $559.82 / $723.90 / $1,490.56	Professional	TC	$559.82	$723.90	$1,490.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,268.75 / $1,414.80 / $2,313.23	Professional		$1,268.75	$1,414.80	$2,313.23
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $353.75 / $382.05 / $634.74	Professional	26	$353.75	$382.05	$634.74
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $912.50 / $1,035.45 / $1,678.49	Professional	TC	$912.50	$1,035.45	$1,678.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $483.64 / $1,279.20 / $2,097.90	Professional		$483.64	$1,279.20	$2,097.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $282.70 / $426.00 / $634.74	Professional	26	$282.70	$426.00	$634.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $756.71 / $1,126.50 / $1,678.49	Professional	TC	$756.71	$1,126.50	$1,678.49
United Facility/Professional Professional Modifier Low / Median / High Price $699.86 / $1,282.53 / $2,119.92	Professional		$699.86	$1,282.53	$2,119.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $153.34 / $422.43 / $673.07	Professional	26	$153.34	$422.43	$673.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $555.79 / $860.43 / $1,446.86	Professional	TC	$555.79	$860.43	$1,446.86