Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $175.09 / $175.09 / $175.09	Facility	26	$175.09	$175.09	$175.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.02 / $384.26 / $947.85	Professional		$330.02	$384.26	$947.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $55.45 / $192.83	Professional	26	$49.03	$55.45	$192.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $280.99 / $328.80 / $755.02	Professional	TC	$280.99	$328.80	$755.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $941.05 / $941.05 / $1,058.04	Professional		$941.05	$941.05	$1,058.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $180.36 / $180.36 / $206.74	Professional	26	$180.36	$180.36	$206.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $760.69 / $760.69 / $851.30	Professional	TC	$760.69	$760.69	$851.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $487.83 / $914.10 / $1,648.50	Professional		$487.83	$914.10	$1,648.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $133.43 / $160.11 / $171.85	Professional	26	$133.43	$160.11	$171.85
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $628.33 / $753.99 / $809.28	Professional	TC	$628.33	$753.99	$809.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,177.50 / $1,297.34 / $1,723.86	Professional		$1,177.50	$1,297.34	$1,723.86
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $206.25 / $222.75 / $301.95	Professional	26	$206.25	$222.75	$301.95
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $971.25 / $1,074.59 / $1,421.91	Professional	TC	$971.25	$1,074.59	$1,421.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.83 / $1,283.75 / $2,394.67	Professional		$487.83	$1,283.75	$2,394.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $199.20 / $249.00 / $381.60	Professional	26	$199.20	$249.00	$381.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $851.30 / $1,269.00 / $2,013.09	Professional	TC	$851.30	$1,269.00	$2,013.09
United Facility/Professional Professional Modifier Low / Median / High Price $564.02 / $846.44 / $1,269.66	Professional		$564.02	$846.44	$1,269.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.07 / $165.40 / $248.10	Professional	26	$88.07	$165.40	$248.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $475.95 / $681.04 / $1,021.56	Professional	TC	$475.95	$681.04	$1,021.56