Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $1,548.82	Professional		$371.54	$446.68	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $263.03	Professional	26	$74.13	$85.11	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $354.81 / $1,202.26	Professional	TC	$281.84	$354.81	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $251.19 / $275.42	Professional	26	$251.19	$251.19	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional	TC	$1,071.52	$1,071.52	$1,071.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $954.99 / $1,230.27	Professional		$398.11	$954.99	$1,230.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $177.83 / $229.09	Professional	26	$85.11	$177.83	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $776.25 / $1,000.00	Professional	TC	$323.59	$776.25	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,621.81 / $2,137.96	Professional		$1,445.44	$1,621.81	$2,137.96
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $288.40 / $398.11	Professional	26	$275.42	$288.40	$398.11
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.90 / $1,318.26 / $1,737.80	Professional	TC	$1,174.90	$1,318.26	$1,737.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $537.03 / $1,348.96	Professional		$371.54	$537.03	$1,348.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $275.42	Professional	26	$72.44	$104.71	$275.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $426.58 / $1,071.52	Professional	TC	$302.00	$426.58	$1,071.52
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,071.52 / $1,621.81	Professional		$562.34	$1,071.52	$1,621.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $218.78 / $323.59	Professional	26	$123.03	$218.78	$323.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $851.14 / $1,288.25	Professional	TC	$436.52	$851.14	$1,288.25