Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $36.93 / $36.93	Facility	26	$36.93	$36.93	$36.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $43.59 / $141.54	Professional		$35.67	$43.59	$141.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $12.35 / $43.32	Professional	26	$10.60	$12.35	$43.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $31.24 / $88.11	Professional	TC	$25.05	$31.24	$88.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.79 / $109.86 / $155.87	Professional		$65.79	$109.86	$155.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $38.86 / $44.52	Professional	26	$18.16	$38.86	$44.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.64 / $71.00 / $115.26	Professional	TC	$47.64	$71.00	$115.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.09 / $127.11 / $272.14	Professional		$105.09	$127.11	$272.14
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $35.60 / $101.79	Professional	26	$29.10	$35.60	$101.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.08 / $92.19 / $219.83	Professional	TC	$71.08	$92.19	$219.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $176.85 / $265.97	Professional		$141.25	$176.85	$265.97
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $52.20 / $80.45	Professional	26	$45.00	$52.20	$80.45
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.25 / $129.60 / $185.51	Professional	TC	$96.25	$129.60	$185.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.48 / $141.25 / $253.16	Professional		$56.48	$141.25	$253.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.00 / $54.00 / $80.45	Professional	26	$36.00	$54.00	$80.45
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $78.00 / $124.50 / $185.51	Professional	TC	$78.00	$124.50	$185.51
United Facility/Professional Professional Modifier Low / Median / High Price $53.81 / $111.69 / $253.99	Professional		$53.81	$111.69	$253.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $53.34 / $89.55	Professional	26	$16.89	$53.34	$89.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.92 / $81.62 / $156.19	Professional	TC	$36.92	$81.62	$156.19