Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	26	$73.00	$73.00	$73.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.90 / $258.89 / $635.05	Professional		$221.90	$258.89	$635.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $23.33 / $80.40	Professional	26	$20.60	$23.33	$80.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.28 / $235.56 / $554.66	Professional	TC	$201.28	$235.56	$554.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.71 / $620.71 / $706.32	Professional		$620.71	$620.71	$706.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.70 / $75.70 / $86.01	Professional	26	$75.70	$75.70	$86.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $545.01 / $545.01 / $620.30	Professional	TC	$545.01	$545.01	$620.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $330.13 / $622.02 / $1,121.75	Professional		$330.13	$622.02	$1,121.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.80 / $66.95 / $71.87	Professional	26	$55.80	$66.95	$71.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $462.55 / $555.05 / $595.76	Professional	TC	$462.55	$555.05	$595.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $801.25 / $881.55 / $1,173.03	Professional		$801.25	$881.55	$1,173.03
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.25 / $91.80 / $126.27	Professional	26	$86.25	$91.80	$126.27
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $715.00 / $789.75 / $1,046.76	Professional	TC	$715.00	$789.75	$1,046.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $330.13 / $868.75 / $1,617.78	Professional		$330.13	$868.75	$1,617.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $82.80 / $103.50 / $159.94	Professional	26	$82.80	$103.50	$159.94
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $620.30 / $925.50 / $1,457.83	Professional	TC	$620.30	$925.50	$1,457.83
United Facility/Professional Professional Modifier Low / Median / High Price $378.32 / $565.05 / $847.59	Professional		$378.32	$565.05	$847.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.14 / $68.80 / $103.20	Professional	26	$37.14	$68.80	$103.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $341.18 / $496.26 / $744.39	Professional	TC	$341.18	$496.26	$744.39