Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $305.16 / $501.03 / $1,253.42	Facility		$305.16	$501.03	$1,253.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.85 / $65.26 / $136.02	Facility	26	$63.85	$65.26	$136.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.43 / $181.30 / $305.16	Professional		$127.43	$181.30	$305.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $29.07 / $91.48	Professional	26	$20.29	$29.07	$91.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.95 / $152.22 / $241.32	Professional	TC	$106.95	$152.22	$241.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.44 / $466.44 / $466.44	Facility		$466.44	$466.44	$466.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.07 / $231.74 / $442.04	Professional		$141.07	$231.74	$442.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $34.79 / $84.77	Professional	26	$23.34	$34.79	$84.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.73 / $188.73 / $357.27	Professional	TC	$117.73	$188.73	$357.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $144.13 / $249.54 / $356.84	Facility		$144.13	$249.54	$356.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $331.70 / $412.41 / $800.37	Professional		$331.70	$412.41	$800.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.18 / $65.01 / $152.16	Professional	26	$54.18	$65.01	$152.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $289.50 / $347.40 / $648.22	Professional	TC	$289.50	$347.40	$648.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.70 / $583.20 / $777.75	Professional		$436.70	$583.20	$777.75
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.52 / $91.80 / $123.68	Professional	26	$74.52	$91.80	$123.68
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $358.60 / $491.40 / $655.14	Professional	TC	$358.60	$491.40	$655.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $170.29 / $249.54 / $382.66	Facility		$170.29	$249.54	$382.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $167.13 / $419.44 / $763.61	Professional		$167.13	$419.44	$763.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $100.05 / $132.76	Professional	26	$43.78	$100.05	$132.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $205.41 / $532.15 / $683.02	Professional	TC	$205.41	$532.15	$683.02
United Facility/Professional Professional Modifier Low / Median / High Price $271.61 / $353.62 / $707.24	Professional		$271.61	$353.62	$707.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $67.81 / $135.63	Professional	26	$28.00	$67.81	$135.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.47 / $285.80 / $571.60	Professional	TC	$160.47	$285.80	$571.60