Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $537.03 / $645.65	Facility	26	$346.74	$537.03	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $1,778.28	Professional		$331.13	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $144.54 / $446.68	Professional	26	$104.71	$144.54	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $691.83	Professional	TC	$223.87	$316.23	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,122.02 / $1,258.93	Professional		$1,047.13	$1,122.02	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $354.81 / $407.38	Professional	26	$213.80	$354.81	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $794.33 / $891.25	Professional	TC	$691.83	$794.33	$891.25
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $602.56 / $645.65	Facility	26	$537.03	$602.56	$645.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $977.24 / $1,905.46	Professional		$501.19	$977.24	$1,905.46
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $323.59 / $616.60	Professional	26	$154.88	$323.59	$616.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $630.96 / $891.25	Professional	TC	$380.19	$630.96	$891.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,479.11 / $2,511.89	Professional		$1,288.25	$1,479.11	$2,511.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $436.52 / $724.44	Professional	26	$407.38	$436.52	$724.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,047.13 / $1,737.80	Professional	TC	$891.25	$1,047.13	$1,737.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $891.25 / $1,122.02	Professional		$602.56	$891.25	$1,122.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $213.80 / $407.38	Professional	26	$93.33	$213.80	$407.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $691.83 / $794.33	Professional	TC	$269.15	$691.83	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,380.38 / $2,041.74	Professional		$954.99	$1,380.38	$2,041.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $354.81 / $691.83	Professional	26	$234.42	$354.81	$691.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $954.99 / $1,621.81	Professional	TC	$645.65	$954.99	$1,621.81