Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $773.02 / $1,749.74 / $1,749.74	Professional		$773.02	$1,749.74	$1,749.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $286.88 / $649.36 / $1,006.40	Professional	26	$286.88	$649.36	$1,006.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $486.14 / $1,100.38 / $1,100.38	Professional	TC	$486.14	$1,100.38	$1,100.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.49 / $295.49 / $295.49	Professional		$295.49	$295.49	$295.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.77 / $153.77 / $153.77	Professional	26	$153.77	$153.77	$153.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.72 / $141.72 / $141.72	Professional	TC	$141.72	$141.72	$141.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,044.15 / $1,044.15 / $2,247.00	Professional		$1,044.15	$1,044.15	$2,247.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $394.48 / $394.48 / $394.48	Professional	26	$394.48	$394.48	$394.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $649.69 / $649.69 / $649.69	Professional	TC	$649.69	$649.69	$649.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $577.59 / $1,605.00 / $2,349.71	Professional		$577.59	$1,605.00	$2,349.71
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $196.14 / $522.50 / $764.94	Professional	26	$196.14	$522.50	$764.94
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $381.44 / $1,082.50 / $1,584.78	Professional	TC	$381.44	$1,082.50	$1,584.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $295.49 / $1,622.50 / $2,107.15	Professional		$295.49	$1,622.50	$2,107.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $153.77 / $522.50 / $801.05	Professional	26	$153.77	$522.50	$801.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $141.72 / $1,100.00 / $1,306.09	Professional	TC	$141.72	$1,100.00	$1,306.09
United Facility/Professional Professional Modifier Low / Median / High Price $1,546.23 / $1,546.23 / $1,546.23	Professional		$1,546.23	$1,546.23	$1,546.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $625.35 / $625.35 / $625.35	Professional	26	$625.35	$625.35	$625.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $920.88 / $920.88 / $920.88	Professional	TC	$920.88	$920.88	$920.88