Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $1,289.70 / $1,289.70 / $1,289.70	Facility	26	$1,289.70	$1,289.70	$1,289.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,889.42 / $2,326.09 / $5,577.77	Professional		$1,889.42	$2,326.09	$5,577.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $347.37 / $436.76 / $1,689.91	Professional	26	$347.37	$436.76	$1,689.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,542.03 / $1,920.41 / $4,129.91	Professional	TC	$1,542.03	$1,920.41	$4,129.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,222.30 / $5,222.30 / $5,700.30	Professional		$5,222.30	$5,222.30	$5,700.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $1,250.44 / $1,250.44 / $1,473.27	Professional	26	$1,250.44	$1,250.44	$1,473.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3,971.85 / $3,971.85 / $4,227.03	Professional	TC	$3,971.85	$3,971.85	$4,227.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,614.88 / $5,393.46 / $9,726.50	Professional		$2,614.88	$5,393.46	$9,726.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,027.80 / $1,233.35 / $1,323.81	Professional	26	$1,027.80	$1,233.35	$1,323.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $3,466.73 / $4,160.07 / $4,465.14	Professional	TC	$3,466.73	$4,160.07	$4,465.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,881.25 / $7,473.60 / $16,790.25	Professional		$6,881.25	$7,473.60	$16,790.25
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $1,490.00 / $1,686.15 / $3,635.60	Professional	26	$1,490.00	$1,686.15	$3,635.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5,358.75 / $5,787.45 / $13,154.65	Professional	TC	$5,358.75	$5,787.45	$13,154.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,914.06 / $6,920.00 / $15,138.75	Professional		$3,914.06	$6,920.00	$15,138.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $1,473.27 / $1,798.50 / $3,635.60	Professional	26	$1,473.27	$1,798.50	$3,635.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $4,227.03 / $6,303.00 / $13,154.65	Professional	TC	$4,227.03	$6,303.00	$13,154.65
United Facility/Professional Professional Modifier Low / Median / High Price $2,807.40 / $6,840.36 / $26,094.61	Professional		$2,807.40	$6,840.36	$26,094.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $532.19 / $1,767.93 / $6,744.31	Professional	26	$532.19	$1,767.93	$6,744.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $2,275.21 / $3,585.14 / $19,350.30	Professional	TC	$2,275.21	$3,585.14	$19,350.30