Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.42 / $323.42 / $323.42	Facility	26	$323.42	$323.42	$323.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.20 / $383.87 / $804.21	Professional	TC	$290.20	$383.87	$804.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $724.00 / $929.28 / $1,150.89	Professional	TC	$724.00	$929.28	$1,150.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $980.12 / $1,267.34 / $1,595.55	Professional	TC	$980.12	$1,267.34	$1,595.55
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $606.44 / $1,570.00 / $2,141.10	Professional	TC	$606.44	$1,570.00	$2,141.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $641.00 / $1,391.25 / $2,499.90	Professional	TC	$641.00	$1,391.25	$2,499.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $881.86 / $920.72 / $1,566.17	Professional	TC	$881.86	$920.72	$1,566.17