Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.01 / $66.08 / $66.08	Facility	26	$48.01	$66.08	$66.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $58.30 / $189.23	Professional		$47.68	$58.30	$189.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.82 / $60.26	Professional	26	$13.58	$15.82	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $42.47 / $103.95	Professional	TC	$34.09	$42.47	$103.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.13 / $147.09 / $186.93	Professional		$79.13	$147.09	$186.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $49.76 / $57.02	Professional	26	$23.55	$49.76	$57.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.58 / $97.33 / $134.56	Professional	TC	$55.58	$97.33	$134.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $126.95 / $152.34 / $329.12	Professional		$126.95	$152.34	$329.12
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.88 / $48.36 / $132.28	Professional	26	$39.88	$48.36	$132.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.03 / $107.70 / $256.62	Professional	TC	$85.03	$107.70	$256.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.50 / $213.30 / $321.83	Professional		$172.50	$213.30	$321.83
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $62.10 / $102.81	Professional	26	$57.50	$62.10	$102.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.75 / $151.19 / $218.40	Professional	TC	$113.75	$151.19	$218.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $172.50 / $314.89	Professional		$67.97	$172.50	$314.89
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $69.00 / $102.81	Professional	26	$46.30	$69.00	$102.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $98.44 / $147.00 / $216.44	Professional	TC	$98.44	$147.00	$216.44
United Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $135.75 / $312.62	Professional		$73.22	$135.75	$312.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $47.47 / $114.68	Professional	26	$20.69	$47.47	$114.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.53 / $96.22 / $189.37	Professional	TC	$52.53	$96.22	$189.37