Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.52 / $72.52 / $674.24	Facility		$72.52	$72.52	$674.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $506.56 / $1,146.59 / $1,146.59	Professional		$506.56	$1,146.59	$1,146.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.76 / $368.39 / $749.00	Professional	26	$162.76	$368.39	$749.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $343.80 / $778.21 / $778.21	Professional	TC	$343.80	$778.21	$778.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.30 / $210.30 / $210.30	Professional		$210.30	$210.30	$210.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.47 / $107.47 / $107.47	Professional	26	$107.47	$107.47	$107.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.83 / $102.83 / $102.83	Professional	TC	$102.83	$102.83	$102.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $136.50 / $609.16 / $1,505.00	Professional		$136.50	$609.16	$1,505.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.49 / $223.49 / $223.49	Professional	26	$223.49	$223.49	$223.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $467.00 / $467.00 / $467.00	Professional	TC	$467.00	$467.00	$467.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $379.56 / $1,075.00 / $1,573.80	Professional		$379.56	$1,075.00	$1,573.80
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.80 / $358.50 / $525.00	Professional	26	$110.80	$358.50	$525.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.76 / $778.75 / $1,140.08	Professional	TC	$268.76	$778.75	$1,140.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $210.30 / $1,080.00 / $1,387.50	Professional		$210.30	$1,080.00	$1,387.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $107.47 / $296.25 / $525.00	Professional	26	$107.47	$296.25	$525.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $102.83 / $783.75 / $936.10	Professional	TC	$102.83	$783.75	$936.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,006.95 / $1,006.95 / $1,006.95	Professional		$1,006.95	$1,006.95	$1,006.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $354.78 / $354.78 / $354.78	Professional	26	$354.78	$354.78	$354.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $652.16 / $652.16 / $652.16	Professional	TC	$652.16	$652.16	$652.16