Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $316.23 / $1,000.00	Professional		$229.09	$316.23	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $100.00 / $295.12	Professional	26	$77.62	$100.00	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $549.54	Professional	TC	$144.54	$218.78	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $831.76 / $851.14	Professional		$758.58	$831.76	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $245.47 / $302.00	Professional	26	$162.18	$245.47	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $562.34 / $575.44	Professional	TC	$457.09	$562.34	$575.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $1,023.29	Professional		$380.19	$616.60	$1,023.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $239.88 / $389.05	Professional	26	$128.82	$239.88	$389.05
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $398.11 / $575.44	Professional	TC	$263.03	$398.11	$575.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,621.81	Professional		$870.96	$1,000.00	$1,621.81
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $331.13 / $549.54	Professional	26	$302.00	$331.13	$549.54
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $660.69 / $1,096.48	Professional	TC	$575.44	$660.69	$1,096.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $776.25	Professional		$354.81	$575.44	$776.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $234.42 / $302.00	Professional	26	$69.18	$234.42	$302.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $457.09 / $575.44	Professional	TC	$169.82	$457.09	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $912.01 / $2,290.87	Professional		$446.68	$912.01	$2,290.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $363.08 / $794.33	Professional	26	$208.93	$363.08	$794.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $549.54 / $1,479.11	Professional	TC	$363.08	$549.54	$1,479.11