Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $54.95 / $91.20	Facility	26	$41.69	$54.95	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $165.96	Professional		$30.20	$52.48	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $51.29	Professional	26	$10.96	$16.98	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $83.18	Professional	TC	$20.89	$36.31	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $154.88	Professional		$85.11	$109.65	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $41.69 / $46.77	Professional	26	$25.12	$41.69	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $77.62 / $109.65	Professional	TC	$69.18	$77.62	$109.65
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $54.95 / $91.20	Facility	26	$40.74	$54.95	$91.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $107.15 / $173.78	Professional		$46.77	$107.15	$173.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $38.02 / $61.66	Professional	26	$15.49	$38.02	$61.66
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $77.62 / $109.65	Professional	TC	$38.02	$77.62	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $245.47	Professional		$134.90	$169.82	$245.47
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $51.29 / $87.10	Professional	26	$47.86	$51.29	$87.10
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $169.82	Professional	TC	$83.18	$120.23	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $83.18 / $112.20	Professional		$38.02	$83.18	$112.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $25.12 / $46.77	Professional	26	$10.72	$25.12	$46.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $81.28	Professional	TC	$23.99	$33.88	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $213.80	Professional		$93.33	$104.71	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.90 / $85.11	Professional	26	$32.36	$38.90	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $131.83	Professional	TC	$54.95	$64.57	$131.83