Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $353.96 / $814.73 / $886.86	Facility	26	$353.96	$814.73	$886.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.52 / $409.55 / $1,142.54	Professional		$335.52	$409.55	$1,142.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $116.71 / $503.64	Professional	26	$100.31	$116.71	$503.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $235.21 / $292.83 / $638.90	Professional	TC	$235.21	$292.83	$638.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $494.28 / $973.00 / $1,235.44	Professional		$494.28	$973.00	$1,235.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.20 / $276.00 / $387.23	Professional	26	$171.20	$276.00	$387.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.07 / $681.10 / $870.87	Professional	TC	$323.07	$681.10	$870.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $795.73 / $954.87 / $2,095.23	Professional		$795.73	$954.87	$2,095.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $272.52 / $334.06 / $821.65	Professional	26	$272.52	$334.06	$821.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $485.04 / $627.84 / $1,273.58	Professional	TC	$485.04	$627.84	$1,273.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.00 / $1,435.20 / $2,373.41	Professional		$1,230.00	$1,435.20	$2,373.41
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $420.00 / $454.95 / $748.73	Professional	26	$420.00	$454.95	$748.73
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $808.75 / $998.40 / $1,560.56	Professional	TC	$808.75	$998.40	$1,560.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $464.72 / $1,237.50 / $2,264.06	Professional		$464.72	$1,237.50	$2,264.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $291.89 / $502.50 / $748.73	Professional	26	$291.89	$502.50	$748.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $788.40 / $1,017.00 / $1,730.00	Professional	TC	$788.40	$1,017.00	$1,730.00
United Facility/Professional Professional Modifier Low / Median / High Price $879.66 / $1,319.49 / $2,271.08	Professional		$879.66	$1,319.49	$2,271.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.90 / $499.29 / $797.16	Professional	26	$120.90	$499.29	$797.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $546.12 / $823.88 / $1,535.46	Professional	TC	$546.12	$823.88	$1,535.46