Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.90 / $103.90 / $103.90	Facility	26	$103.90	$103.90	$103.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.41 / $374.44 / $479.61	Professional		$299.41	$374.44	$479.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.71 / $47.56 / $84.96	Professional	26	$39.71	$47.56	$84.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $258.50 / $326.88 / $394.65	Professional	TC	$258.50	$326.88	$394.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.42 / $373.90 / $782.18	Professional		$243.42	$373.90	$782.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.08 / $61.74 / $134.82	Professional	26	$37.08	$61.74	$134.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.34 / $312.14 / $647.36	Professional	TC	$206.34	$312.14	$647.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $572.35 / $716.16 / $1,370.62	Professional		$572.35	$716.16	$1,370.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.38 / $109.65 / $244.12	Professional	26	$91.38	$109.65	$244.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $505.43 / $606.51 / $1,126.50	Professional	TC	$505.43	$606.51	$1,126.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $813.24 / $1,003.05 / $1,350.54	Professional		$813.24	$1,003.05	$1,350.54
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $118.80 / $149.85 / $204.60	Professional	26	$118.80	$149.85	$204.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $694.44 / $853.20 / $1,152.58	Professional	TC	$694.44	$853.20	$1,152.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $317.27 / $729.12 / $1,349.75	Professional		$317.27	$729.12	$1,349.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.66 / $159.50 / $211.64	Professional	26	$69.66	$159.50	$211.64
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $330.76 / $932.35 / $1,237.13	Professional	TC	$330.76	$932.35	$1,237.13
United Facility/Professional Professional Modifier Low / Median / High Price $399.55 / $625.74 / $1,251.48	Professional		$399.55	$625.74	$1,251.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.10 / $107.86 / $204.14	Professional	26	$56.10	$107.86	$204.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $341.18 / $517.88 / $1,035.76	Professional	TC	$341.18	$517.88	$1,035.76