Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $230.56 / $230.56 / $230.56	Facility	26	$230.56	$230.56	$230.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $388.06 / $1,532.30	Professional		$342.85	$388.06	$1,532.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.56 / $77.61 / $328.06	Professional	26	$68.56	$77.61	$328.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $310.45 / $1,204.24	Professional	TC	$274.27	$310.45	$1,204.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,337.72 / $1,337.72 / $1,337.72	Professional		$1,337.72	$1,337.72	$1,337.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $248.81 / $248.81 / $272.57	Professional	26	$248.81	$248.81	$272.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,065.15 / $1,065.15 / $1,065.15	Professional	TC	$1,065.15	$1,065.15	$1,065.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $532.48 / $1,132.44 / $2,042.25	Professional		$532.48	$1,132.44	$2,042.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $175.48 / $210.57 / $226.01	Professional	26	$175.48	$210.57	$226.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $768.23 / $921.87 / $989.47	Professional	TC	$768.23	$921.87	$989.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,401.25 / $1,609.20 / $2,135.61	Professional		$1,401.25	$1,609.20	$2,135.61
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $271.25 / $291.60 / $397.11	Professional	26	$271.25	$291.60	$397.11
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,127.50 / $1,317.60 / $1,738.50	Professional	TC	$1,127.50	$1,317.60	$1,738.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $532.48 / $1,914.00 / $2,773.99	Professional		$532.48	$1,914.00	$2,773.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $260.39 / $327.00 / $500.42	Professional	26	$260.39	$327.00	$500.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,127.50 / $1,587.00 / $2,273.58	Professional	TC	$1,127.50	$1,587.00	$2,273.58
United Facility/Professional Professional Modifier Low / Median / High Price $557.88 / $1,016.92 / $1,605.27	Professional		$557.88	$1,016.92	$1,605.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.04 / $217.90 / $327.08	Professional	26	$122.04	$217.90	$327.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $435.84 / $799.02 / $1,278.18	Professional	TC	$435.84	$799.02	$1,278.18