Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $327.72 / $327.72 / $327.72	Facility	26	$327.72	$327.72	$327.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.81 / $216.84 / $764.42	Professional		$179.81	$216.84	$764.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $106.16 / $431.56	Professional	26	$90.92	$106.16	$431.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.89 / $93.13 / $644.65	Professional	TC	$88.89	$93.13	$644.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.32 / $446.32 / $448.14	Professional		$446.32	$446.32	$448.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $326.92 / $326.92 / $375.93	Professional	26	$326.92	$326.92	$375.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $72.20 / $119.40	Professional	TC	$72.20	$72.20	$119.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $426.96 / $770.00	Professional		$178.13	$426.96	$770.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $261.20 / $313.44 / $336.43	Professional	26	$261.20	$313.44	$336.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.63 / $113.55 / $121.88	Professional	TC	$94.63	$113.55	$121.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $468.75 / $575.10 / $1,143.75	Professional		$468.75	$575.10	$1,143.75
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $378.75 / $429.30 / $924.15	Professional	26	$378.75	$429.30	$924.15
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.00 / $146.25 / $222.50	Professional	TC	$90.00	$146.25	$222.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $278.44 / $532.50 / $1,031.25	Professional		$278.44	$532.50	$1,031.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $375.93 / $460.50 / $924.15	Professional	26	$375.93	$460.50	$924.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $90.00 / $135.00 / $222.50	Professional	TC	$90.00	$135.00	$222.50
United Facility/Professional Professional Modifier Low / Median / High Price $358.52 / $537.78 / $2,051.52	Professional		$358.52	$537.78	$2,051.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $139.55 / $451.11 / $1,720.90	Professional	26	$139.55	$451.11	$1,720.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.78 / $191.54 / $360.28	Professional	TC	$57.78	$191.54	$360.28