Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $23.12 / $50.58	Professional		$19.00	$23.12	$50.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.74 / $13.40 / $21.94	Professional	TC	$10.74	$13.40	$21.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $54.46 / $60.40	Professional		$27.14	$54.46	$60.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.88 / $22.79 / $30.25	Professional	TC	$13.88	$22.79	$30.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.85 / $51.42 / $108.41	Professional		$42.85	$51.42	$108.41
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.19 / $56.49	Professional	TC	$20.42	$26.19	$56.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $68.90 / $110.00	Professional		$33.75	$68.90	$110.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.25 / $41.40 / $60.75	Professional	TC	$31.25	$41.40	$60.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.05 / $61.00 / $109.52	Professional		$24.05	$61.00	$109.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.80 / $34.50 / $54.00	Professional	TC	$28.80	$34.50	$54.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $48.04 / $109.50	Professional		$30.24	$48.04	$109.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.22 / $18.95 / $45.80	Professional	TC	$18.22	$18.95	$45.80