Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $692.06 / $692.06 / $692.06	Facility	26	$692.06	$692.06	$692.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $504.95 / $613.49 / $2,254.48	Professional		$504.95	$613.49	$2,254.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $236.52 / $1,194.86	Professional	26	$198.28	$236.52	$1,194.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.66 / $381.89 / $732.54	Professional	TC	$306.66	$381.89	$732.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,259.58 / $1,259.58 / $1,531.21	Professional		$1,259.58	$1,259.58	$1,531.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $714.04 / $714.04 / $791.28	Professional	26	$714.04	$714.04	$791.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $545.54 / $545.54 / $739.93	Professional	TC	$545.54	$545.54	$739.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $662.15 / $1,415.82 / $2,553.25	Professional		$662.15	$1,415.82	$2,553.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $550.70 / $660.84 / $709.30	Professional	26	$550.70	$660.84	$709.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $629.15 / $754.98 / $810.35	Professional	TC	$629.15	$754.98	$810.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,742.50 / $1,946.70 / $4,251.70	Professional		$1,742.50	$1,946.70	$4,251.70
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $800.00 / $904.50 / $1,952.00	Professional	26	$800.00	$904.50	$1,952.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $942.50 / $1,042.20 / $2,299.69	Professional	TC	$942.50	$1,042.20	$2,299.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $982.75 / $1,802.50 / $3,833.50	Professional		$982.75	$1,802.50	$3,833.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $791.28 / $966.00 / $1,952.00	Professional	26	$791.28	$966.00	$1,952.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $739.93 / $1,104.00 / $2,299.69	Professional	TC	$739.93	$1,104.00	$2,299.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,224.96 / $1,837.44 / $7,009.47	Professional		$1,224.96	$1,837.44	$7,009.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $304.04 / $949.53 / $3,622.28	Professional	26	$304.04	$949.53	$3,622.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $591.94 / $887.91 / $3,387.19	Professional	TC	$591.94	$887.91	$3,387.19