Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.96 / $467.96 / $467.96	Facility	26	$467.96	$467.96	$467.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.18 / $296.83 / $922.87	Professional		$255.18	$296.83	$922.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $151.16 / $613.21	Professional	26	$131.81	$151.16	$613.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.37 / $145.68 / $386.89	Professional	TC	$123.37	$145.68	$386.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.18 / $771.18 / $920.49	Professional		$771.18	$771.18	$920.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $452.88 / $452.88 / $535.21	Professional	26	$452.88	$452.88	$535.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $318.30 / $318.30 / $385.28	Professional	TC	$318.30	$318.30	$385.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $390.45 / $850.08 / $1,533.00	Professional		$390.45	$850.08	$1,533.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $373.60 / $448.32 / $481.20	Professional	26	$373.60	$448.32	$481.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $334.78 / $401.73 / $431.19	Professional	TC	$334.78	$401.73	$431.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,027.50 / $1,163.70 / $2,507.10	Professional		$1,027.50	$1,163.70	$2,507.10
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $540.00 / $611.54 / $1,317.60	Professional	26	$540.00	$611.54	$1,317.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $487.50 / $552.15 / $1,189.50	Professional	TC	$487.50	$552.15	$1,189.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $578.91 / $1,077.50 / $2,260.50	Professional		$578.91	$1,077.50	$2,260.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $535.21 / $654.00 / $1,317.60	Professional	26	$535.21	$654.00	$1,317.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $385.28 / $576.00 / $1,189.50	Professional	TC	$385.28	$576.00	$1,189.50
United Facility/Professional Professional Modifier Low / Median / High Price $422.88 / $1,104.59 / $4,213.83	Professional		$422.88	$1,104.59	$4,213.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $223.39 / $428.16 / $2,450.03	Professional	26	$223.39	$428.16	$2,450.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.49 / $323.22 / $1,763.80	Professional	TC	$199.49	$323.22	$1,763.80