Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $1,174.90	Professional		$549.54	$724.44	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $269.15	Professional	26	$102.33	$134.90	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $588.84 / $912.01	Professional	TC	$446.68	$588.84	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,380.38 / $1,819.70	Professional		$1,258.93	$1,380.38	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $316.23 / $426.58	Professional	26	$281.84	$316.23	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $1,071.52 / $1,380.38	Professional	TC	$977.24	$1,071.52	$1,380.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,698.24 / $2,818.38	Professional		$645.65	$1,698.24	$2,818.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $354.81 / $602.56	Professional	26	$123.03	$354.81	$602.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $1,380.38 / $2,187.76	Professional	TC	$512.86	$1,380.38	$2,187.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,511.89 / $3,162.28	Professional		$1,202.26	$2,511.89	$3,162.28
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $467.74 / $616.60	Professional	26	$234.42	$467.74	$616.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $2,041.74 / $2,570.40	Professional	TC	$954.99	$2,041.74	$2,570.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,380.38 / $1,737.80	Professional		$707.95	$1,380.38	$1,737.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $208.93 / $426.58	Professional	26	$114.82	$208.93	$426.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $912.01 / $1,380.38	Professional	TC	$457.09	$912.01	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $1,445.44 / $3,162.28	Professional		$489.78	$1,445.44	$3,162.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $346.74 / $741.31	Professional	26	$169.82	$346.74	$741.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $1,096.48 / $2,398.83	Professional	TC	$588.84	$1,096.48	$2,398.83