Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $314.17 / $314.17 / $314.17	Facility	26	$314.17	$314.17	$314.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $343.67 / $1,065.58	Professional		$293.74	$343.67	$1,065.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $102.65 / $359.85	Professional	26	$89.57	$102.65	$359.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $241.02 / $705.75	Professional	TC	$204.15	$241.02	$705.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $832.62 / $832.62 / $1,021.13	Professional		$832.62	$832.62	$1,021.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $306.61 / $306.61 / $360.47	Professional	26	$306.61	$306.61	$360.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $526.01 / $526.01 / $660.66	Professional	TC	$526.01	$526.01	$660.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $444.60 / $1,017.93 / $1,835.75	Professional		$444.60	$1,017.93	$1,835.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $250.68 / $300.81 / $322.87	Professional	26	$250.68	$300.81	$322.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $597.60 / $717.12 / $769.71	Professional	TC	$597.60	$717.12	$769.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,170.00 / $1,410.75 / $2,854.80	Professional		$1,170.00	$1,410.75	$2,854.80
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $362.50 / $411.75 / $884.50	Professional	26	$362.50	$411.75	$884.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $807.50 / $999.00 / $1,970.30	Professional	TC	$807.50	$999.00	$1,970.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $642.46 / $1,306.25 / $2,574.00	Professional		$642.46	$1,306.25	$2,574.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $360.47 / $441.00 / $884.50	Professional	26	$360.47	$441.00	$884.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $660.66 / $985.50 / $1,970.30	Professional	TC	$660.66	$985.50	$1,970.30
United Facility/Professional Professional Modifier Low / Median / High Price $480.73 / $1,225.34 / $4,674.47	Professional		$480.73	$1,225.34	$4,674.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $151.22 / $432.57 / $1,650.18	Professional	26	$151.22	$432.57	$1,650.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $329.50 / $792.78 / $3,024.29	Professional	TC	$329.50	$792.78	$3,024.29