Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.64 / $265.64 / $265.64	Facility	26	$265.64	$265.64	$265.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,848.09	Professional		$475.00	$522.50	$1,848.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $520.75	Professional	26	$140.00	$154.00	$520.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,327.34	Professional	TC	$335.00	$368.50	$1,327.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.13 / $1,125.00 / $1,265.10	Professional		$514.13	$1,125.00	$1,265.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.51 / $290.23 / $337.50	Professional	26	$128.51	$290.23	$337.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.62 / $787.50 / $974.88	Professional	TC	$385.62	$787.50	$974.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $818.27 / $994.65 / $2,147.09	Professional		$818.27	$994.65	$2,147.09
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.78 / $249.59 / $614.63	Professional	26	$203.78	$249.59	$614.63
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $579.77 / $750.12 / $1,532.52	Professional	TC	$579.77	$750.12	$1,532.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,281.25 / $1,479.40 / $2,438.39	Professional		$1,281.25	$1,479.40	$2,438.39
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $315.00 / $340.20 / $565.46	Professional	26	$315.00	$340.20	$565.46
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $966.25 / $1,120.84 / $1,872.93	Professional	TC	$966.25	$1,120.84	$1,872.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $476.23 / $1,298.75 / $2,398.19	Professional		$476.23	$1,298.75	$2,398.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $274.47 / $379.50 / $565.46	Professional	26	$274.47	$379.50	$565.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $844.06 / $1,257.00 / $1,872.93	Professional	TC	$844.06	$1,257.00	$1,872.93
United Facility/Professional Professional Modifier Low / Median / High Price $833.05 / $963.47 / $1,753.00	Professional		$833.05	$963.47	$1,753.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $260.95 / $470.29	Professional	26	$122.70	$260.95	$470.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $675.23 / $844.05 / $1,297.00	Professional	TC	$675.23	$844.05	$1,297.00