Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $282.27 / $282.27 / $282.27	Facility	26	$282.27	$282.27	$282.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $299.29 / $510.40	Professional		$243.78	$299.29	$510.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $66.45 / $310.88	Professional	26	$56.82	$66.45	$310.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.17 / $199.52 / $232.83	Professional	TC	$181.17	$199.52	$232.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.30 / $557.54 / $586.07	Professional		$251.30	$557.54	$586.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.93 / $198.15 / $333.42	Professional	26	$117.93	$198.15	$333.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.19 / $224.12 / $387.93	Professional	TC	$107.19	$224.12	$387.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $393.83 / $483.38 / $1,078.44	Professional		$393.83	$483.38	$1,078.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $220.78 / $267.39 / $779.68	Professional	26	$220.78	$267.39	$779.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.92 / $207.66 / $494.91	Professional	TC	$163.92	$207.66	$494.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $608.75 / $685.10 / $1,106.00	Professional		$608.75	$685.10	$1,106.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $341.25 / $395.85 / $605.69	Professional	26	$341.25	$395.85	$605.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $267.50 / $341.80 / $558.00	Professional	TC	$267.50	$341.80	$558.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.20 / $586.07 / $1,104.08	Professional		$239.20	$586.07	$1,104.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $198.15 / $406.50 / $605.69	Professional	26	$198.15	$406.50	$605.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $258.00 / $350.45 / $558.00	Professional	TC	$258.00	$350.45	$558.00
United Facility/Professional Professional Modifier Low / Median / High Price $446.04 / $575.70 / $910.00	Professional		$446.04	$575.70	$910.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.80 / $333.43 / $496.00	Professional	26	$97.80	$333.43	$496.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.30 / $268.95 / $486.55	Professional	TC	$179.30	$268.95	$486.55