Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.63 / $115.63 / $115.63	Facility	26	$115.63	$115.63	$115.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $361.50 / $804.60	Professional		$171.22	$361.50	$804.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $35.42 / $132.43	Professional	26	$30.35	$35.42	$132.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $175.40 / $672.17	Professional	TC	$140.87	$175.40	$672.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.56 / $474.56 / $814.31	Professional		$474.56	$474.56	$814.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.91 / $108.91 / $130.82	Professional	26	$108.91	$108.91	$130.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $365.65 / $365.65 / $683.49	Professional	TC	$365.65	$365.65	$683.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $372.40 / $780.21 / $1,407.00	Professional		$372.40	$780.21	$1,407.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.38 / $109.65 / $117.69	Professional	26	$91.38	$109.65	$117.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $558.78 / $670.53 / $719.70	Professional	TC	$558.78	$670.53	$719.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $980.00 / $1,090.80 / $2,391.19	Professional		$980.00	$1,090.80	$2,391.19
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $132.50 / $151.19 / $323.30	Professional	26	$132.50	$151.19	$323.30
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $847.50 / $939.60 / $2,067.90	Professional	TC	$847.50	$939.60	$2,067.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $474.56 / $1,010.00 / $2,156.00	Professional		$474.56	$1,010.00	$2,156.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $130.82 / $160.50 / $323.30	Professional	26	$130.82	$160.50	$323.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $683.49 / $1,017.00 / $2,067.90	Professional	TC	$683.49	$1,017.00	$2,067.90
United Facility/Professional Professional Modifier Low / Median / High Price $260.52 / $977.16 / $3,727.67	Professional		$260.52	$977.16	$3,727.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.23 / $104.66 / $598.90	Professional	26	$47.23	$104.66	$598.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.30 / $820.17 / $3,128.77	Professional	TC	$213.30	$820.17	$3,128.77