Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.44 / $157.86 / $357.71	Facility	26	$154.44	$157.86	$357.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.98 / $387.08 / $638.60	Professional		$263.98	$387.08	$638.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.44 / $115.08 / $251.01	Professional	26	$70.44	$115.08	$251.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.77 / $316.64 / $484.16	Professional	TC	$169.77	$316.64	$484.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $433.28 / $824.85	Professional		$257.80	$433.28	$824.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $104.83 / $200.69	Professional	26	$55.95	$104.83	$200.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.19 / $324.25 / $624.16	Professional	TC	$205.19	$324.25	$624.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $466.83 / $757.89 / $1,487.38	Professional		$466.83	$757.89	$1,487.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.00 / $157.19 / $362.69	Professional	26	$131.00	$157.19	$362.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $500.55 / $600.66 / $1,124.69	Professional	TC	$500.55	$600.66	$1,124.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $976.25 / $1,103.20 / $1,414.00	Professional		$976.25	$1,103.20	$1,414.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $178.20 / $220.05 / $296.45	Professional	26	$178.20	$220.05	$296.45
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $694.44 / $851.85 / $1,132.77	Professional	TC	$694.44	$851.85	$1,132.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $359.29 / $782.04 / $1,414.00	Professional		$359.29	$782.04	$1,414.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $115.02 / $244.50 / $313.61	Professional	26	$115.02	$244.50	$313.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $328.88 / $926.55 / $1,192.88	Professional	TC	$328.88	$926.55	$1,192.88
United Facility/Professional Professional Modifier Low / Median / High Price $540.69 / $659.88 / $1,319.76	Professional		$540.69	$659.88	$1,319.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.00 / $160.56 / $321.12	Professional	26	$127.00	$160.56	$321.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $370.99 / $499.32 / $945.04	Professional	TC	$370.99	$499.32	$945.04