Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $467.12 / $467.12 / $467.12	Facility	26	$467.12	$467.12	$467.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $317.47 / $1,414.43	Professional		$317.47	$317.47	$1,414.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $131.81 / $535.02	Professional	26	$131.81	$131.81	$535.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $185.65 / $879.41	Professional	TC	$185.65	$185.65	$879.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $931.87 / $931.87 / $1,259.19	Professional		$931.87	$931.87	$1,259.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $452.88 / $452.88 / $534.20	Professional	26	$452.88	$452.88	$534.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.98 / $478.98 / $724.99	Professional	TC	$478.98	$478.98	$724.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $516.79 / $1,350.78 / $2,436.00	Professional		$516.79	$1,350.78	$2,436.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $372.80 / $447.36 / $480.17	Professional	26	$372.80	$447.36	$480.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $752.88 / $903.45 / $969.70	Professional	TC	$752.88	$903.45	$969.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,360.00 / $1,860.30 / $3,318.40	Professional		$1,360.00	$1,860.30	$3,318.40
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $540.00 / $610.20 / $1,317.60	Professional	26	$540.00	$610.20	$1,317.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $820.00 / $1,250.09 / $2,000.80	Professional	TC	$820.00	$1,250.09	$2,000.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $710.94 / $1,722.50 / $2,992.00	Professional		$710.94	$1,722.50	$2,992.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $534.20 / $652.50 / $1,317.60	Professional	26	$534.20	$652.50	$1,317.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $724.99 / $1,100.75 / $2,000.80	Professional	TC	$724.99	$1,100.75	$2,000.80
United Facility/Professional Professional Modifier Low / Median / High Price $523.70 / $1,511.01 / $5,764.20	Professional		$523.70	$1,511.01	$5,764.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $223.39 / $641.04 / $2,445.44	Professional	26	$223.39	$641.04	$2,445.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.31 / $869.97 / $3,318.75	Professional	TC	$300.31	$869.97	$3,318.75