Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.24 / $157.24 / $157.24	Facility	26	$157.24	$157.24	$157.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.73 / $393.21 / $1,024.18	Professional		$318.73	$393.21	$1,024.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.85 / $53.40 / $173.17	Professional	26	$45.85	$53.40	$173.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $272.87 / $339.81 / $851.00	Professional	TC	$272.87	$339.81	$851.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $909.56 / $909.56 / $1,155.11	Professional		$909.56	$909.56	$1,155.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $160.76 / $160.76 / $185.80	Professional	26	$160.76	$160.76	$185.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $748.80 / $748.80 / $969.32	Professional	TC	$748.80	$748.80	$969.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $465.98 / $983.97 / $1,774.50	Professional		$465.98	$983.97	$1,774.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.68 / $143.61 / $154.13	Professional	26	$119.68	$143.61	$154.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $700.30 / $840.36 / $901.99	Professional	TC	$700.30	$840.36	$901.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,226.25 / $1,406.70 / $1,855.62	Professional		$1,226.25	$1,406.70	$1,855.62
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $185.00 / $199.80 / $270.83	Professional	26	$185.00	$199.80	$270.83
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,041.25 / $1,206.90 / $1,584.78	Professional	TC	$1,041.25	$1,206.90	$1,584.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $465.98 / $1,302.50 / $2,294.14	Professional		$465.98	$1,302.50	$2,294.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $177.60 / $223.50 / $335.90	Professional	26	$177.60	$223.50	$335.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $969.32 / $1,444.50 / $1,958.25	Professional	TC	$969.32	$1,444.50	$1,958.25
United Facility/Professional Professional Modifier Low / Median / High Price $482.84 / $834.86 / $1,386.15	Professional		$482.84	$834.86	$1,386.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.75 / $146.80 / $222.96	Professional	26	$73.75	$146.80	$222.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $409.09 / $688.06 / $1,163.19	Professional	TC	$409.09	$688.06	$1,163.19