Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.61 / $32.61 / $32.61	Facility	26	$32.61	$32.61	$32.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $42.81 / $139.08	Professional		$35.04	$42.81	$139.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $12.35 / $35.92	Professional	26	$10.60	$12.35	$35.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $30.45 / $75.98	Professional	TC	$24.44	$30.45	$75.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.88 / $108.16 / $134.29	Professional		$56.88	$108.16	$134.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.70 / $35.90 / $39.45	Professional	26	$15.70	$35.90	$39.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.18 / $69.30 / $98.38	Professional	TC	$41.18	$69.30	$98.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $109.65 / $234.85	Professional		$79.56	$109.65	$234.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $30.74 / $89.90	Professional	26	$25.08	$30.74	$89.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.72 / $79.56 / $187.59	Professional	TC	$62.72	$79.56	$187.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.50 / $152.55 / $238.50	Professional		$137.50	$152.55	$238.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $46.50 / $72.00	Professional	26	$38.75	$46.50	$72.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.50 / $110.70 / $158.69	Professional	TC	$92.50	$110.70	$158.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.08 / $135.60 / $230.21	Professional		$52.08	$135.60	$230.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.00 / $48.00 / $72.00	Professional	26	$36.00	$48.00	$72.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $71.20 / $106.50 / $159.94	Professional	TC	$71.20	$106.50	$159.94
United Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $91.56 / $222.53	Professional		$63.32	$91.56	$222.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $35.56 / $79.34	Professional	26	$16.45	$35.56	$79.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.85 / $70.43 / $143.19	Professional	TC	$40.85	$70.43	$143.19