Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.15 / $27.15 / $37.38	Facility	26	$27.15	$27.15	$37.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $30.49 / $101.75	Professional		$24.92	$30.49	$101.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.89 / $35.61	Professional	26	$7.33	$9.89	$35.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.93 / $63.88	Professional	TC	$17.57	$21.93	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.48 / $76.54 / $111.55	Professional		$47.48	$76.54	$111.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $25.91 / $32.02	Professional	26	$13.25	$25.91	$32.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.24 / $50.62 / $81.48	Professional	TC	$34.24	$50.62	$81.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $91.23 / $194.81	Professional		$75.23	$91.23	$194.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.54 / $27.33 / $74.81	Professional	26	$22.54	$27.33	$74.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.96 / $66.00 / $155.41	Professional	TC	$51.96	$66.00	$155.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $126.90 / $192.21	Professional		$106.25	$126.90	$192.21
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $35.10 / $58.11	Professional	26	$30.00	$35.10	$58.11
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.25 / $91.80 / $134.10	Professional	TC	$76.25	$91.80	$134.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $106.25 / $185.65	Professional		$40.44	$106.25	$185.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $39.00 / $58.11	Professional	26	$24.00	$39.00	$58.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $90.00 / $134.10	Professional	TC	$59.00	$90.00	$134.10
United Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $76.68 / $185.27	Professional		$31.04	$76.68	$185.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $25.62 / $55.09	Professional	26	$12.94	$25.62	$55.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.71 / $59.28 / $120.87	Professional	TC	$24.71	$59.28	$120.87