Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,199.12 / $2,199.12 / $2,199.12	Facility		$2,199.12	$2,199.12	$2,199.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.75 / $477.03 / $500.88	Professional		$210.75	$477.03	$500.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.56 / $189.13 / $1,663.20	Professional	26	$83.56	$189.13	$1,663.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.19 / $287.89 / $287.89	Professional	TC	$127.19	$287.89	$287.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.75 / $126.75 / $126.75	Professional		$126.75	$126.75	$126.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $74.73 / $74.73	Professional	26	$74.73	$74.73	$74.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.02 / $52.02 / $52.02	Professional	TC	$52.02	$52.02	$52.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $292.45 / $624.75 / $633.41	Professional		$292.45	$624.75	$633.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.64 / $114.64 / $114.64	Professional	26	$114.64	$114.64	$114.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	TC	$177.83	$177.83	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $446.25 / $653.30	Professional		$171.15	$446.25	$653.30
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.14 / $150.00 / $219.60	Professional	26	$72.14	$150.00	$219.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.02 / $296.25 / $433.71	Professional	TC	$99.02	$296.25	$433.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $126.75 / $451.25 / $701.15	Professional		$126.75	$451.25	$701.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $150.00 / $240.50	Professional	26	$74.73	$150.00	$240.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $52.02 / $301.25 / $460.65	Professional	TC	$52.02	$301.25	$460.65
United Facility/Professional Professional Modifier Low / Median / High Price $461.46 / $461.46 / $461.46	Professional		$461.46	$461.46	$461.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $182.34 / $182.34 / $182.34	Professional	26	$182.34	$182.34	$182.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.12 / $279.12 / $279.12	Professional	TC	$279.12	$279.12	$279.12