Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.58 / $126.58 / $126.58	Facility	26	$126.58	$126.58	$126.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.22 / $389.72 / $525.08	Professional		$219.22	$389.72	$525.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.56 / $59.08 / $103.51	Professional	26	$48.56	$59.08	$103.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.96 / $330.64 / $421.58	Professional	TC	$169.96	$330.64	$421.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.33 / $426.81 / $804.77	Professional		$259.33	$426.81	$804.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.79 / $67.73 / $165.06	Professional	26	$45.79	$67.73	$165.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.54 / $369.82 / $639.70	Professional	TC	$213.54	$369.82	$639.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $601.23 / $745.26 / $1,527.73	Professional		$601.23	$745.26	$1,527.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $108.35 / $130.02 / $302.08	Professional	26	$108.35	$130.02	$302.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $512.70 / $615.24 / $1,225.58	Professional	TC	$512.70	$615.24	$1,225.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $958.75 / $1,111.05 / $1,374.85	Professional		$958.75	$1,111.05	$1,374.85
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.72 / $183.60 / $245.22	Professional	26	$144.72	$183.60	$245.22
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $695.52 / $927.45 / $1,160.22	Professional	TC	$695.52	$927.45	$1,160.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $362.11 / $792.82 / $1,374.85	Professional		$362.11	$792.82	$1,374.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $84.92 / $195.75 / $259.74	Professional	26	$84.92	$195.75	$259.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $369.82 / $952.50 / $1,221.74	Professional	TC	$369.82	$952.50	$1,221.74
United Facility/Professional Professional Modifier Low / Median / High Price $331.42 / $643.82 / $1,287.64	Professional		$331.42	$643.82	$1,287.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.20 / $132.06 / $264.12	Professional	26	$64.20	$132.06	$264.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $368.76 / $511.76 / $1,023.52	Professional	TC	$368.76	$511.76	$1,023.52