Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.99 / $35.79 / $77.29	Facility	26	$25.99	$35.79	$77.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $36.68 / $118.64	Professional		$29.89	$36.68	$118.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $29.93	Professional	26	$7.33	$8.55	$29.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $28.13 / $83.45	Professional	TC	$22.57	$28.13	$83.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $91.82 / $135.71	Professional		$56.92	$91.82	$135.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.76 / $26.76 / $30.66	Professional	26	$12.76	$26.76	$30.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.16 / $65.06 / $106.82	Professional	TC	$44.16	$65.06	$106.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.36 / $109.65 / $231.06	Professional		$69.36	$109.65	$231.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $24.50 / $69.36	Professional	26	$20.23	$24.50	$69.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.81 / $85.38 / $203.71	Professional	TC	$65.81	$85.38	$203.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.25 / $152.55 / $227.97	Professional		$121.25	$152.55	$227.97
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $36.25 / $55.88	Professional	26	$31.25	$36.25	$55.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.00 / $120.15 / $172.10	Professional	TC	$90.00	$120.15	$172.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.84 / $121.25 / $220.31	Professional		$48.84	$121.25	$220.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $37.50 / $56.75	Professional	26	$25.00	$37.50	$56.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $72.00 / $115.50 / $171.99	Professional	TC	$72.00	$115.50	$171.99
United Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $89.83 / $216.98	Professional		$42.34	$89.83	$216.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $25.54 / $61.69	Professional	26	$11.68	$25.54	$61.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.83 / $77.33 / $155.36	Professional	TC	$31.83	$77.33	$155.36