Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	26	$29.46	$29.46	$29.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $35.35 / $108.06	Professional		$28.91	$35.35	$108.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.93 / $35.04	Professional	26	$8.51	$9.93	$35.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $25.42 / $84.51	Professional	TC	$20.39	$25.42	$84.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $86.91 / $119.90	Professional		$50.45	$86.91	$119.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $30.34 / $35.72	Professional	26	$14.23	$30.34	$35.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $56.57 / $87.52	Professional	TC	$36.22	$56.57	$87.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $97.05 / $209.94	Professional		$58.23	$97.05	$209.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $27.77 / $81.25	Professional	26	$22.65	$27.77	$81.25
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.04 / $69.87 / $166.92	Professional	TC	$55.04	$69.87	$166.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $136.35 / $205.62	Professional		$110.00	$136.35	$205.62
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $37.79 / $64.81	Professional	26	$35.00	$37.79	$64.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.75 / $98.55 / $140.81	Professional	TC	$73.75	$98.55	$140.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $110.00 / $195.18	Professional		$43.45	$110.00	$195.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $43.50 / $64.81	Professional	26	$29.00	$43.50	$64.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $62.00 / $94.50 / $140.81	Professional	TC	$62.00	$94.50	$140.81
United Facility/Professional Professional Modifier Low / Median / High Price $52.57 / $108.72 / $198.85	Professional		$52.57	$108.72	$198.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $29.74 / $71.84	Professional	26	$13.80	$29.74	$71.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.64 / $65.91 / $127.00	Professional	TC	$38.64	$65.91	$127.00