Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.30 / $30.30 / $30.30	Facility	26	$30.30	$30.30	$30.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.26 / $23.34 / $56.26	Professional		$19.26	$23.34	$56.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $10.70 / $33.38	Professional	26	$9.14	$10.70	$33.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $12.62 / $22.88	Professional	TC	$10.11	$12.62	$22.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $59.74 / $62.01	Professional		$29.10	$59.74	$62.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $33.59 / $36.74	Professional	26	$15.22	$33.59	$36.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.88 / $23.80 / $28.42	Professional	TC	$13.88	$23.80	$28.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.83 / $55.32 / $120.40	Professional		$21.83	$55.32	$120.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.83 / $29.10 / $70.68	Professional	26	$21.83	$29.10	$70.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.19 / $58.76	Professional	TC	$20.42	$26.19	$58.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $76.95 / $120.69	Professional		$70.00	$76.95	$120.69
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.50 / $41.60 / $67.05	Professional	26	$37.50	$41.60	$67.05
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.25 / $36.45 / $54.00	Professional	TC	$31.25	$36.45	$54.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.60 / $64.80 / $120.31	Professional		$26.60	$64.80	$120.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $45.00 / $67.05	Professional	26	$31.52	$45.00	$67.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.00 / $36.00 / $54.48	Professional	TC	$26.00	$36.00	$54.48
United Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $50.40 / $98.00	Professional		$46.40	$50.40	$98.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $44.10 / $57.00	Professional	26	$13.93	$44.10	$57.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $23.80 / $41.00	Professional	TC	$19.04	$23.80	$41.00