Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.78 / $901.86 / $4,250.70	Facility		$547.78	$901.86	$4,250.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.47 / $375.22 / $519.57	Facility	26	$217.47	$375.22	$519.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.66 / $299.05 / $703.74	Professional		$254.66	$299.05	$703.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $94.75 / $542.52	Professional	26	$70.64	$94.75	$542.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $183.15 / $204.30 / $330.31	Professional	TC	$183.15	$204.30	$330.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $353.81 / $639.91	Professional		$210.55	$353.81	$639.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.72 / $101.06 / $259.45	Professional	26	$64.72	$101.06	$259.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.60 / $203.24 / $408.00	Professional	TC	$148.60	$203.24	$408.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $432.63 / $613.52 / $3,862.06	Facility		$432.63	$613.52	$3,862.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $323.24 / $563.79 / $831.90	Professional		$323.24	$563.79	$831.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $163.35 / $196.02 / $458.19	Professional	26	$163.35	$196.02	$458.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $306.48 / $367.77 / $689.33	Professional	TC	$306.48	$367.77	$689.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $704.00 / $795.15 / $1,046.82	Professional		$704.00	$795.15	$1,046.82
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $198.00 / $272.70 / $369.66	Professional	26	$198.00	$272.70	$369.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $470.00 / $522.45 / $675.50	Professional	TC	$470.00	$522.45	$675.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $221.84 / $438.23 / $626.66	Facility		$221.84	$438.23	$626.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $270.05 / $608.14 / $1,039.50	Professional		$270.05	$608.14	$1,039.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $115.61 / $301.50 / $386.88	Professional	26	$115.61	$301.50	$386.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $235.55 / $567.00 / $727.27	Professional	TC	$235.55	$567.00	$727.27
United Facility/Professional Professional Modifier Low / Median / High Price $393.71 / $511.94 / $831.90	Professional		$393.71	$511.94	$831.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.79 / $207.56 / $337.29	Professional	26	$104.79	$207.56	$337.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.50 / $304.38 / $463.99	Professional	TC	$281.50	$304.38	$463.99