Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $155.81 / $155.81 / $155.81	Facility	26	$155.81	$155.81	$155.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.98 / $365.60 / $800.74	Professional		$287.98	$365.60	$800.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.33 / $312.36 / $673.32	Professional	TC	$242.33	$312.36	$673.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $814.98 / $922.68 / $1,151.75	Professional		$814.98	$922.68	$1,151.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $684.63 / $773.22 / $950.16	Professional	TC	$684.63	$773.22	$950.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $969.22 / $1,213.95 / $1,577.80	Professional		$969.22	$1,213.95	$1,577.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $814.31 / $1,052.88 / $1,325.63	Professional	TC	$814.31	$1,052.88	$1,325.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $566.67 / $1,515.00 / $2,109.90	Professional		$566.67	$1,515.00	$2,109.90
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $490.36 / $1,306.25 / $1,788.15	Professional	TC	$490.36	$1,306.25	$1,788.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.76 / $1,029.20 / $1,864.50	Professional		$512.76	$1,029.20	$1,864.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $534.50 / $1,155.00 / $2,084.55	Professional	TC	$534.50	$1,155.00	$2,084.55
United Facility/Professional Professional Modifier Low / Median / High Price $897.30 / $921.40 / $1,842.80	Professional		$897.30	$921.40	$1,842.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $760.12 / $925.36 / $1,640.99	Professional	TC	$760.12	$925.36	$1,640.99