Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $382.95 / $382.95 / $382.95	Facility	26	$382.95	$382.95	$382.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $2,034.78	Professional		$475.00	$522.50	$2,034.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $750.72	Professional	26	$140.00	$154.00	$750.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,284.05	Professional	TC	$335.00	$368.50	$1,284.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.73 / $1,125.00 / $1,380.40	Professional		$549.73	$1,125.00	$1,380.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $184.45 / $337.50 / $420.14	Professional	26	$184.45	$337.50	$420.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $365.28 / $787.50 / $960.26	Professional	TC	$365.28	$787.50	$960.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $887.10 / $1,064.52 / $2,366.27	Professional		$887.10	$1,064.52	$2,366.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $294.35 / $361.40 / $889.30	Professional	26	$294.35	$361.40	$889.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $550.03 / $711.30 / $1,476.92	Professional	TC	$550.03	$711.30	$1,476.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,371.25 / $1,563.90 / $2,641.77	Professional		$1,371.25	$1,563.90	$2,641.77
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $453.75 / $491.40 / $806.84	Professional	26	$453.75	$491.40	$806.84
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $916.25 / $1,085.50 / $1,834.94	Professional	TC	$916.25	$1,085.50	$1,834.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.83 / $1,401.25 / $2,580.90	Professional		$524.83	$1,401.25	$2,580.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $337.50 / $541.50 / $806.84	Professional	26	$337.50	$541.50	$806.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $827.32 / $1,231.50 / $1,834.94	Professional	TC	$827.32	$1,231.50	$1,834.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,021.90 / $1,532.85 / $2,171.54	Professional		$1,021.90	$1,532.85	$2,171.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $182.53 / $540.05 / $765.09	Professional	26	$182.53	$540.05	$765.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $661.86 / $992.79 / $1,406.45	Professional	TC	$661.86	$992.79	$1,406.45