Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $524.81 / $1,479.11	Professional		$426.58	$524.81	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $239.88 / $794.33	Professional	26	$186.21	$239.88	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $295.12 / $691.83	Professional	TC	$239.88	$295.12	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,513.56	Professional		$1,380.38	$1,380.38	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $676.08 / $676.08 / $794.33	Professional	26	$676.08	$676.08	$794.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $724.44 / $741.31	Professional	TC	$724.44	$724.44	$741.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,174.90 / $1,513.56	Professional		$512.86	$1,174.90	$1,513.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $562.34 / $724.44	Professional	26	$234.42	$562.34	$724.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $630.96 / $812.83	Professional	TC	$295.12	$630.96	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,905.46 / $4,365.16	Professional		$1,778.28	$1,905.46	$4,365.16
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $851.14 / $912.01 / $1,949.84	Professional	26	$851.14	$912.01	$1,949.84
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $1,000.00 / $2,344.23	Professional	TC	$977.24	$1,000.00	$2,344.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,023.29 / $1,513.56	Professional		$467.74	$1,023.29	$1,513.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $302.00 / $794.33	Professional	26	$213.80	$302.00	$794.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $741.31	Professional	TC	$257.04	$371.54	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,445.44 / $6,918.31	Professional		$707.95	$1,445.44	$6,918.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $954.99 / $3,630.78	Professional	26	$331.13	$954.99	$3,630.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $891.25 / $3,388.44	Professional	TC	$371.54	$891.25	$3,388.44