Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.77 / $295.77 / $295.77	Facility	26	$295.77	$295.77	$295.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,840.49 / $2,840.49 / $4,963.22	Professional		$2,840.49	$2,840.49	$4,963.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2,501.71 / $2,501.71 / $4,394.97	Professional	TC	$2,501.71	$2,501.71	$4,394.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,469.46 / $2,469.46 / $2,956.80	Professional		$2,469.46	$2,469.46	$2,956.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2,122.27 / $2,122.27 / $2,616.86	Professional	TC	$2,122.27	$2,122.27	$2,616.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.38 / $2,736.51 / $4,935.00	Professional		$1,047.38	$2,736.51	$4,935.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,039.45 / $2,447.34 / $2,626.81	Professional	TC	$2,039.45	$2,447.34	$2,626.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,756.25 / $3,827.25 / $6,725.25	Professional		$2,756.25	$3,827.25	$6,725.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2,391.25 / $3,423.60 / $5,834.65	Professional	TC	$2,391.25	$3,423.60	$5,834.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,559.55 / $3,543.75 / $6,063.75	Professional		$1,559.55	$3,543.75	$6,063.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $2,391.25 / $3,170.00 / $5,834.65	Professional	TC	$2,391.25	$3,170.00	$5,834.65
United Facility/Professional Professional Modifier Low / Median / High Price $733.29 / $1,975.58 / $11,304.66	Professional		$733.29	$1,975.58	$11,304.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $595.32 / $2,546.73 / $9,715.25	Professional	TC	$595.32	$2,546.73	$9,715.25