Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $510.91 / $510.91 / $510.91	Facility	26	$510.91	$510.91	$510.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.61 / $316.85 / $609.47	Professional		$234.61	$316.85	$609.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $149.00 / $188.30 / $417.78	Professional	26	$149.00	$188.30	$417.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.61 / $116.86 / $191.69	Professional	TC	$85.61	$116.86	$191.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $644.78 / $742.66 / $984.00	Professional		$644.78	$742.66	$984.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $429.23 / $490.58 / $661.03	Professional	26	$429.23	$490.58	$661.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.55 / $252.08 / $322.97	Professional	TC	$215.55	$252.08	$322.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $687.38 / $824.85 / $1,199.73	Professional		$687.38	$824.85	$1,199.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $443.15 / $531.78 / $831.22	Professional	26	$443.15	$531.78	$831.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.35 / $293.07 / $368.48	Professional	TC	$226.35	$293.07	$368.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.28 / $1,062.50 / $1,555.50	Professional		$390.28	$1,062.50	$1,555.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $249.07 / $675.36 / $891.87	Professional	26	$249.07	$675.36	$891.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.80 / $388.80 / $552.66	Professional	TC	$145.80	$388.80	$552.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $360.82 / $722.48 / $1,345.60	Professional		$360.82	$722.48	$1,345.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $273.00 / $652.79 / $1,064.70	Professional	26	$273.00	$652.79	$1,064.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $158.00 / $386.25 / $631.79	Professional	TC	$158.00	$386.25	$631.79
United Facility/Professional Professional Modifier Low / Median / High Price $731.17 / $787.20 / $1,699.45	Professional		$731.17	$787.20	$1,699.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $467.41 / $528.82 / $1,057.64	Professional	26	$467.41	$528.82	$1,057.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.38 / $260.27 / $516.76	Professional	TC	$258.38	$260.27	$516.76