Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $346.74 / $794.33	Professional		$288.40	$346.74	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $54.95 / $138.04	Professional	26	$39.81	$54.95	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $302.00 / $660.69	Professional	TC	$251.19	$302.00	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $891.25	Professional		$676.08	$676.08	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $128.82 / $151.36	Professional	26	$128.82	$128.82	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $537.03 / $741.31	Professional	TC	$537.03	$537.03	$741.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $645.65 / $831.76	Professional		$398.11	$645.65	$831.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $97.72 / $125.89	Professional	26	$42.66	$97.72	$125.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $549.54 / $707.95	Professional	TC	$288.40	$549.54	$707.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,096.48 / $1,445.44	Professional		$1,071.52	$1,096.48	$1,445.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $158.49 / $218.78	Professional	26	$151.36	$158.49	$218.78
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $912.01 / $933.25 / $1,230.27	Professional	TC	$912.01	$933.25	$1,230.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $891.25	Professional		$288.40	$416.87	$891.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $57.54 / $151.36	Professional	26	$39.81	$57.54	$151.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $354.81 / $741.31	Professional	TC	$251.19	$354.81	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $741.31 / $1,071.52	Professional		$338.84	$741.31	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $120.23 / $269.15	Professional	26	$58.88	$120.23	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $616.60 / $891.25	Professional	TC	$275.42	$616.60	$891.25