Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	26	$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $691.83	Professional		$208.93	$338.84	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $263.03	Professional	26	$72.44	$104.71	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $239.88 / $489.78	Professional	TC	$134.90	$239.88	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $812.83 / $891.25	Professional		$660.69	$812.83	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $245.47 / $281.84	Professional	26	$147.91	$245.47	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $489.78 / $549.54	Professional	TC	$416.87	$489.78	$549.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $1,122.02	Professional		$524.81	$630.96	$1,122.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $223.87 / $426.58	Professional	26	$158.49	$223.87	$426.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $380.19 / $616.60	Professional	TC	$331.13	$380.19	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $933.25 / $1,584.89	Professional		$831.76	$933.25	$1,584.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $302.00 / $512.86	Professional	26	$281.84	$302.00	$512.86
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $645.65 / $1,071.52	Professional	TC	$549.54	$645.65	$1,071.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $562.34 / $891.25	Professional		$389.05	$562.34	$891.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $147.91 / $281.84	Professional	26	$63.10	$147.91	$281.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $416.87 / $489.78	Professional	TC	$162.18	$416.87	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $933.25 / $1,905.46	Professional		$616.60	$933.25	$1,905.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $281.84 / $478.63	Professional	26	$194.98	$281.84	$478.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $588.84 / $1,548.82	Professional	TC	$389.05	$588.84	$1,548.82