Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.93 / $131.93 / $131.93	Facility	26	$131.93	$131.93	$131.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.83 / $480.46 / $1,161.84	Professional		$411.83	$480.46	$1,161.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $41.51 / $145.30	Professional	26	$36.71	$41.51	$145.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $375.12 / $438.96 / $1,016.55	Professional	TC	$375.12	$438.96	$1,016.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,304.51 / $1,304.51 / $1,344.56	Professional		$1,304.51	$1,304.51	$1,344.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.11 / $140.11 / $157.06	Professional	26	$140.11	$140.11	$157.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,147.45 / $1,147.45 / $1,204.45	Professional	TC	$1,147.45	$1,147.45	$1,204.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $611.33 / $1,133.43 / $2,044.00	Professional		$611.33	$1,133.43	$2,044.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.08 / $121.29 / $130.18	Professional	26	$101.08	$121.29	$130.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $843.43 / $1,012.11 / $1,086.33	Professional	TC	$843.43	$1,012.11	$1,086.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,460.00 / $1,611.90 / $2,137.44	Professional		$1,460.00	$1,611.90	$2,137.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $156.25 / $167.40 / $228.75	Professional	26	$156.25	$167.40	$228.75
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,303.75 / $1,444.50 / $1,908.69	Professional	TC	$1,303.75	$1,444.50	$1,908.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $611.33 / $1,608.75 / $3,007.06	Professional		$611.33	$1,608.75	$3,007.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $150.00 / $190.50 / $290.20	Professional	26	$150.00	$190.50	$290.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,204.45 / $1,710.00 / $2,716.87	Professional	TC	$1,204.45	$1,710.00	$2,716.87
United Facility/Professional Professional Modifier Low / Median / High Price $700.92 / $1,043.59 / $1,565.40	Professional		$700.92	$1,043.59	$1,565.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $125.48 / $188.49	Professional	26	$65.80	$125.48	$188.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $635.12 / $917.94 / $1,376.91	Professional	TC	$635.12	$917.94	$1,376.91