Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.70 / $256.70 / $256.70	Facility	26	$256.70	$256.70	$256.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,669.70	Professional		$475.00	$522.50	$1,669.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $503.26	Professional	26	$140.00	$154.00	$503.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,166.44	Professional	TC	$335.00	$368.50	$1,166.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.12 / $1,025.00 / $1,141.03	Professional		$460.12	$1,025.00	$1,141.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.13 / $282.08 / $307.50	Professional	26	$123.13	$282.08	$307.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $336.99 / $717.50 / $858.94	Professional	TC	$336.99	$717.50	$858.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $737.56 / $891.78 / $1,936.33	Professional		$737.56	$891.78	$1,936.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.50 / $241.09 / $593.73	Professional	26	$196.50	$241.09	$593.73
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $507.19 / $655.98 / $1,342.61	Professional	TC	$507.19	$655.98	$1,342.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.75 / $1,332.55 / $2,212.65	Professional		$1,148.75	$1,332.55	$2,212.65
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $303.75 / $328.05 / $549.80	Professional	26	$303.75	$328.05	$549.80
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $845.00 / $1,063.00 / $1,662.84	Professional	TC	$845.00	$1,063.00	$1,662.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $429.48 / $1,166.25 / $2,172.39	Professional		$429.48	$1,166.25	$2,172.39
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $264.42 / $369.00 / $549.80	Professional	26	$264.42	$369.00	$549.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $749.65 / $1,116.00 / $1,676.00	Professional	TC	$749.65	$1,116.00	$1,676.00
United Facility/Professional Professional Modifier Low / Median / High Price $842.96 / $1,264.44 / $2,547.00	Professional		$842.96	$1,264.44	$2,547.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.20 / $364.86 / $676.00	Professional	26	$116.20	$364.86	$676.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $599.72 / $788.18 / $1,871.00	Professional	TC	$599.72	$788.18	$1,871.00