Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.15 / $137.15 / $137.15	Facility	26	$137.15	$137.15	$137.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.72 / $709.48 / $709.48	Professional		$329.72	$709.48	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.15 / $257.12 / $257.12	Professional	26	$137.15	$257.12	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.54 / $452.37 / $1,084.92	Professional	TC	$192.54	$452.37	$1,084.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $113.38 / $161.97 / $648.85	Professional		$113.38	$161.97	$648.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.25 / $484.65 / $1,040.05	Professional		$426.25	$484.65	$1,040.05
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $158.75 / $179.55 / $387.35	Professional	26	$158.75	$179.55	$387.35
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $267.50 / $305.10 / $652.70	Professional	TC	$267.50	$305.10	$652.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $253.19 / $517.50 / $1,040.05	Professional		$253.19	$517.50	$1,040.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $158.75 / $192.00 / $387.35	Professional	26	$158.75	$192.00	$387.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $267.50 / $325.50 / $652.70	Professional	TC	$267.50	$325.50	$652.70
United Facility/Professional Professional Modifier Low / Median / High Price $255.22 / $300.52 / $1,500.77	Professional		$255.22	$300.52	$1,500.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.77 / $125.74 / $627.95	Professional	26	$56.77	$125.74	$627.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.80 / $198.45 / $872.82	Professional	TC	$171.80	$198.45	$872.82