Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $292.88 / $292.88 / $292.88	Facility	26	$292.88	$292.88	$292.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $470.80 / $470.80 / $857.00	Professional		$470.80	$470.80	$857.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.26 / $148.26 / $298.89	Professional	TC	$148.26	$148.26	$298.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.58 / $421.58 / $490.11	Professional		$421.58	$421.58	$490.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.89 / $127.89 / $144.43	Professional	TC	$127.89	$127.89	$144.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $198.55 / $423.09 / $763.00	Professional		$198.55	$423.09	$763.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.19 / $156.24 / $167.70	Professional	TC	$130.19	$156.24	$167.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $522.50 / $588.60 / $797.88	Professional		$522.50	$588.60	$797.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.00 / $217.35 / $294.63	Professional	TC	$175.00	$217.35	$294.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $288.75 / $545.00 / $941.42	Professional		$288.75	$545.00	$941.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $144.43 / $216.00 / $328.44	Professional	TC	$144.43	$216.00	$328.44
United Facility/Professional Professional Modifier Low / Median / High Price $248.32 / $392.08 / $588.12	Professional		$248.32	$392.08	$588.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.68 / $115.54 / $173.31	Professional	TC	$110.68	$115.54	$173.31