Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $678.88 / $1,536.65 / $1,536.65	Professional		$678.88	$1,536.65	$1,536.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.90 / $294.02 / $568.79	Professional	26	$129.90	$294.02	$568.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $548.98 / $1,242.61 / $1,242.61	Professional	TC	$548.98	$1,242.61	$1,242.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.33 / $249.33 / $249.33	Professional		$249.33	$249.33	$249.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.25 / $82.25 / $82.25	Professional	26	$82.25	$82.25	$82.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.09 / $167.09 / $167.09	Professional	TC	$167.09	$167.09	$167.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $913.75 / $913.75 / $2,035.25	Professional		$913.75	$913.75	$2,035.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $181.03 / $181.03 / $181.03	Professional	26	$181.03	$181.03	$181.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $732.72 / $732.72 / $732.72	Professional	TC	$732.72	$732.72	$732.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.95 / $1,453.75 / $2,128.29	Professional		$281.95	$1,453.75	$2,128.29
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.28 / $233.75 / $342.21	Professional	26	$86.28	$233.75	$342.21
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.67 / $1,220.00 / $1,786.08	Professional	TC	$195.67	$1,220.00	$1,786.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $249.33 / $1,482.50 / $2,146.00	Professional		$249.33	$1,482.50	$2,146.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $82.25 / $231.25 / $344.10	Professional	26	$82.25	$231.25	$344.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $167.09 / $1,251.25 / $1,801.90	Professional	TC	$167.09	$1,251.25	$1,801.90
United Facility/Professional Professional Modifier Low / Median / High Price $1,437.03 / $1,437.03 / $1,437.03	Professional		$1,437.03	$1,437.03	$1,437.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $283.26 / $283.26 / $283.26	Professional	26	$283.26	$283.26	$283.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,153.77 / $1,153.77 / $1,153.77	Professional	TC	$1,153.77	$1,153.77	$1,153.77