Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $237.10 / $237.10 / $237.10	Facility	26	$237.10	$237.10	$237.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $433.43 / $534.17 / $1,271.14	Professional		$433.43	$534.17	$1,271.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $82.58 / $261.12	Professional	26	$67.62	$82.58	$261.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $365.81 / $455.53 / $1,010.03	Professional	TC	$365.81	$455.53	$1,010.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,306.21 / $1,306.21 / $1,404.75	Professional		$1,306.21	$1,306.21	$1,404.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $245.26 / $245.26 / $279.31	Professional	26	$245.26	$245.26	$279.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,060.95 / $1,060.95 / $1,125.44	Professional	TC	$1,060.95	$1,060.95	$1,125.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $646.00 / $1,226.58 / $2,212.00	Professional		$646.00	$1,226.58	$2,212.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.33 / $216.39 / $232.26	Professional	26	$180.33	$216.39	$232.26
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $841.83 / $1,010.19 / $1,084.27	Professional	TC	$841.83	$1,010.19	$1,084.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,580.00 / $1,753.65 / $2,313.12	Professional		$1,580.00	$1,753.65	$2,313.12
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $278.75 / $301.05 / $408.09	Professional	26	$278.75	$301.05	$408.09
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,301.25 / $1,452.60 / $1,905.03	Professional	TC	$1,301.25	$1,452.60	$1,905.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $646.00 / $1,700.00 / $3,176.15	Professional		$646.00	$1,700.00	$3,176.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $268.80 / $336.00 / $514.13	Professional	26	$268.80	$336.00	$514.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,125.44 / $1,678.50 / $2,662.03	Professional	TC	$1,125.44	$1,678.50	$2,662.03
United Facility/Professional Professional Modifier Low / Median / High Price $918.99 / $1,123.80 / $1,685.70	Professional		$918.99	$1,123.80	$1,685.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $165.02 / $223.44 / $335.16	Professional	26	$165.02	$223.44	$335.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $753.97 / $900.36 / $1,350.54	Professional	TC	$753.97	$900.36	$1,350.54