Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $279.82 / $279.82 / $279.82	Facility	26	$279.82	$279.82	$279.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.81 / $347.33 / $556.46	Professional		$219.81	$347.33	$556.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.25 / $103.75 / $228.82	Professional	26	$82.25	$103.75	$228.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.56 / $253.01 / $327.64	Professional	TC	$137.56	$253.01	$327.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $594.29 / $793.60 / $908.66	Professional		$594.29	$793.60	$908.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $238.64 / $266.52 / $361.09	Professional	26	$238.64	$266.52	$361.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $327.76 / $432.51 / $670.02	Professional	TC	$327.76	$432.51	$670.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $704.35 / $845.22 / $1,153.78	Professional		$704.35	$845.22	$1,153.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $240.98 / $289.17 / $454.76	Professional	26	$240.98	$289.17	$454.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $429.42 / $556.04 / $699.06	Professional	TC	$429.42	$556.04	$699.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.00 / $1,088.75 / $1,483.20	Professional		$386.00	$1,088.75	$1,483.20
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $136.63 / $370.00 / $485.00	Professional	26	$136.63	$370.00	$485.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.52 / $711.90 / $947.20	Professional	TC	$265.52	$711.90	$947.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $367.65 / $693.64 / $1,425.60	Professional		$367.65	$693.64	$1,425.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $149.50 / $361.09 / $581.10	Professional	26	$149.50	$361.09	$581.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $296.50 / $645.00 / $1,124.40	Professional	TC	$296.50	$645.00	$1,124.40
United Facility/Professional Professional Modifier Low / Median / High Price $634.88 / $706.25 / $1,269.76	Professional		$634.88	$706.25	$1,269.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $255.17 / $288.88 / $623.65	Professional	26	$255.17	$288.88	$623.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $346.00 / $451.08 / $692.00	Professional	TC	$346.00	$451.08	$692.00