Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.01 / $531.79 / $531.79	Facility	26	$217.01	$531.79	$531.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,097.40	Professional		$475.00	$522.50	$1,097.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.41 / $154.00 / $425.44	Professional	26	$133.41	$154.00	$425.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $671.97	Professional	TC	$335.00	$368.50	$671.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.54 / $730.74 / $900.00	Professional		$298.54	$730.74	$900.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $237.95 / $270.00	Professional	26	$104.00	$237.95	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.54 / $492.79 / $630.00	Professional	TC	$194.54	$492.79	$630.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $481.15 / $577.38 / $1,277.27	Professional		$481.15	$577.38	$1,277.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.78 / $203.31 / $502.21	Professional	26	$165.78	$203.31	$502.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $292.51 / $378.45 / $775.01	Professional	TC	$292.51	$378.45	$775.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $743.75 / $922.95 / $1,435.14	Professional		$743.75	$922.95	$1,435.14
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $256.25 / $276.75 / $464.88	Professional	26	$256.25	$276.75	$464.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $487.50 / $672.00 / $952.11	Professional	TC	$487.50	$672.00	$952.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $283.30 / $894.40 / $1,416.99	Professional		$283.30	$894.40	$1,416.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $222.64 / $312.00 / $464.88	Professional	26	$222.64	$312.00	$464.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $498.75 / $661.78 / $1,184.00	Professional	TC	$498.75	$661.78	$1,184.00
United Facility/Professional Professional Modifier Low / Median / High Price $548.90 / $823.35 / $1,166.41	Professional		$548.90	$823.35	$1,166.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.40 / $307.77 / $436.60	Professional	26	$99.40	$307.77	$436.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $343.44 / $518.11 / $729.81	Professional	TC	$343.44	$518.11	$729.81