Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $45.02 / $148.50	Professional		$36.88	$45.02	$148.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.40 / $47.61	Professional	26	$11.50	$13.40	$47.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $31.62 / $84.38	Professional	TC	$25.37	$31.62	$84.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $113.10 / $155.69	Professional		$65.76	$113.10	$155.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $42.10 / $51.95	Professional	26	$20.61	$42.10	$51.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.15 / $71.00 / $108.03	Professional	TC	$45.15	$71.00	$108.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $127.11 / $277.08	Professional		$105.93	$127.11	$277.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $40.75 / $119.15	Professional	26	$33.15	$40.75	$119.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.31 / $87.33 / $176.28	Professional	TC	$67.31	$87.33	$176.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $178.20 / $270.44	Professional		$145.00	$178.20	$270.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $55.35 / $93.87	Professional	26	$51.25	$55.35	$93.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.50 / $122.85 / $176.57	Professional	TC	$92.50	$122.85	$176.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $145.00 / $258.20	Professional		$56.78	$145.00	$258.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $63.00 / $93.87	Professional	26	$39.00	$63.00	$93.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $78.00 / $118.50 / $176.57	Professional	TC	$78.00	$118.50	$176.57
United Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $147.41 / $263.89	Professional		$64.84	$147.41	$263.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $43.25 / $104.48	Professional	26	$18.41	$43.25	$104.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $78.19 / $156.19	Professional	TC	$41.39	$78.19	$156.19