Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.49 / $36.31	Professional	26	$7.94	$13.49	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $81.28	Professional	TC	$19.05	$33.11	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.11 / $38.90	Professional	26	$20.89	$33.11	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $75.86 / $100.00	Professional	TC	$66.07	$75.86	$100.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.90 / $77.62	Professional	26	$25.70	$30.90	$77.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $70.79 / $123.03	Professional	TC	$60.26	$70.79	$123.03
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $43.65 / $70.79	Professional	26	$38.90	$43.65	$70.79
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $109.65 / $158.49	Professional	TC	$89.13	$109.65	$158.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $20.89 / $38.90	Professional	26	$9.12	$20.89	$38.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $75.86	Professional	TC	$23.99	$33.88	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $32.36 / $72.44	Professional	26	$27.54	$32.36	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $67.61 / $131.83	Professional	TC	$54.95	$67.61	$131.83