Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.61 / $32.61 / $32.61	Facility	26	$32.61	$32.61	$32.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $122.17 / $175.33	Professional		$37.67	$122.17	$175.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $35.92 / $42.56	Professional	26	$9.98	$35.92	$42.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $86.25 / $132.72	Professional	TC	$27.69	$86.25	$132.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.85 / $102.88 / $147.56	Professional		$61.85	$102.88	$147.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.70 / $34.43 / $39.45	Professional	26	$15.70	$34.43	$39.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.15 / $68.45 / $111.64	Professional	TC	$46.15	$68.45	$111.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.19 / $119.37 / $256.25	Professional		$98.19	$119.37	$256.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $30.74 / $89.90	Professional	26	$25.08	$30.74	$89.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.42 / $89.28 / $212.94	Professional	TC	$70.42	$89.28	$212.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $167.40 / $250.32	Professional		$131.25	$167.40	$250.32
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $44.95 / $71.52	Professional	26	$38.75	$44.95	$71.52
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.50 / $125.55 / $178.80	Professional	TC	$92.50	$125.55	$178.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.51 / $131.25 / $239.63	Professional		$53.51	$131.25	$239.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.00 / $48.00 / $71.52	Professional	26	$32.00	$48.00	$71.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $120.00 / $178.80	Professional	TC	$75.00	$120.00	$178.80
United Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $106.54 / $240.78	Professional		$53.06	$106.54	$240.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.88 / $32.85 / $79.34	Professional	26	$14.88	$32.85	$79.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.72 / $79.89 / $161.44	Professional	TC	$38.72	$79.89	$161.44