Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $322.48 / $322.48 / $322.48	Facility	26	$322.48	$322.48	$322.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.25 / $479.96 / $1,263.13	Professional		$393.25	$479.96	$1,263.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $103.42 / $556.92	Professional	26	$90.71	$103.42	$556.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.52 / $355.54 / $893.77	Professional	TC	$302.52	$355.54	$893.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,090.25 / $1,090.25 / $1,352.10	Professional		$1,090.25	$1,090.25	$1,352.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $311.93 / $311.93 / $370.86	Professional	26	$311.93	$311.93	$370.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $778.32 / $778.32 / $981.24	Professional	TC	$778.32	$778.32	$981.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $620.35 / $1,172.25 / $2,114.00	Professional		$620.35	$1,172.25	$2,114.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $256.35 / $307.62 / $330.18	Professional	26	$256.35	$307.62	$330.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $720.53 / $864.63 / $928.04	Professional	TC	$720.53	$864.63	$928.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,510.00 / $1,653.75 / $3,983.30	Professional		$1,510.00	$1,653.75	$3,983.30
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $373.75 / $422.55 / $911.95	Professional	26	$373.75	$422.55	$911.95
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,113.75 / $1,258.75 / $3,071.35	Professional	TC	$1,113.75	$1,258.75	$3,071.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $934.04 / $1,632.50 / $3,591.50	Professional		$934.04	$1,632.50	$3,591.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $370.86 / $454.50 / $911.95	Professional	26	$370.86	$454.50	$911.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $981.24 / $1,461.00 / $3,071.35	Professional	TC	$981.24	$1,461.00	$3,071.35
United Facility/Professional Professional Modifier Low / Median / High Price $640.42 / $1,081.68 / $6,189.59	Professional		$640.42	$1,081.68	$6,189.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $153.87 / $445.02 / $1,697.67	Professional	26	$153.87	$445.02	$1,697.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $486.56 / $1,177.50 / $4,491.92	Professional	TC	$486.56	$1,177.50	$4,491.92