Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $710.02 / $1,607.14 / $1,607.14	Professional		$710.02	$1,607.14	$1,607.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.79 / $219.10 / $219.10	Professional	26	$96.79	$219.10	$219.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $613.22 / $1,388.04 / $1,388.04	Professional	TC	$613.22	$1,388.04	$1,388.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.87 / $464.87 / $464.87	Professional		$464.87	$464.87	$464.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $58.62 / $58.62	Professional	26	$58.62	$58.62	$58.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $406.25 / $406.25 / $406.25	Professional	TC	$406.25	$406.25	$406.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $941.94 / $941.94 / $2,128.00	Professional		$941.94	$941.94	$2,128.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.46 / $134.46 / $134.46	Professional	26	$134.46	$134.46	$134.46
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $807.50 / $807.50 / $807.50	Professional	TC	$807.50	$807.50	$807.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $704.42 / $1,520.00 / $2,225.28	Professional		$704.42	$1,520.00	$2,225.28
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.95 / $176.25 / $258.02	Professional	26	$66.95	$176.25	$258.02
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $637.47 / $1,343.75 / $1,967.25	Professional	TC	$637.47	$1,343.75	$1,967.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $464.87 / $1,572.50 / $2,784.25	Professional		$464.87	$1,572.50	$2,784.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $175.00 / $268.25	Professional	26	$58.62	$175.00	$268.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $406.25 / $1,397.50 / $2,516.00	Professional	TC	$406.25	$1,397.50	$2,516.00
United Facility/Professional Professional Modifier Low / Median / High Price $652.91 / $652.91 / $1,550.52	Professional		$652.91	$652.91	$1,550.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $211.05 / $211.05 / $211.05	Professional	26	$211.05	$211.05	$211.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,339.47 / $1,339.47 / $1,339.47	Professional	TC	$1,339.47	$1,339.47	$1,339.47