Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $33.03 / $33.03	Facility	26	$23.99	$33.03	$33.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $26.33 / $73.54	Professional		$21.53	$26.33	$73.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.89 / $31.44	Professional	26	$6.74	$7.89	$31.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.78 / $18.44 / $47.11	Professional	TC	$14.78	$18.44	$47.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $64.81 / $86.30	Professional		$37.08	$64.81	$86.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $23.53 / $28.30	Professional	26	$11.77	$23.53	$28.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.30 / $41.28 / $59.78	Professional	TC	$25.30	$41.28	$59.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $70.83 / $152.41	Professional		$58.87	$70.83	$152.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $22.61 / $66.17	Professional	26	$18.60	$22.61	$66.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $48.51 / $96.47	Professional	TC	$18.60	$48.51	$96.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $98.55 / $151.97	Professional		$81.25	$98.55	$151.97
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $31.05 / $51.41	Professional	26	$27.50	$31.05	$51.41
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.75 / $67.50 / $100.58	Professional	TC	$53.75	$67.50	$100.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $81.25 / $145.69	Professional		$31.26	$81.25	$145.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $34.50 / $51.41	Professional	26	$22.00	$34.50	$51.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.00 / $67.50 / $100.58	Professional	TC	$44.00	$67.50	$100.58
United Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $63.59 / $147.36	Professional		$33.42	$63.59	$147.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.09 / $23.56 / $56.91	Professional	26	$10.09	$23.56	$56.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.33 / $43.84 / $90.45	Professional	TC	$23.33	$43.84	$90.45