Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.78 / $46.48 / $76.88	Facility	26	$33.78	$46.48	$76.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $46.85 / $146.15	Professional		$34.17	$46.85	$146.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $16.60 / $60.99	Professional	26	$9.41	$16.60	$60.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $30.84 / $105.23	Professional	TC	$24.75	$30.84	$105.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $102.04 / $139.07	Professional		$59.36	$102.04	$139.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $33.58 / $40.79	Professional	26	$16.19	$33.58	$40.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.17 / $68.45 / $101.99	Professional	TC	$43.17	$68.45	$101.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.76 / $114.51 / $247.28	Professional		$78.76	$114.51	$247.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $31.84 / $93.08	Professional	26	$25.88	$31.84	$93.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.80 / $83.46 / $199.16	Professional	TC	$65.80	$83.46	$199.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $160.65 / $241.38	Professional		$127.50	$160.65	$241.38
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $43.20 / $73.76	Professional	26	$38.75	$43.20	$73.76
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.75 / $117.45 / $167.50	Professional	TC	$88.75	$117.45	$167.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.28 / $127.50 / $227.95	Professional		$51.28	$127.50	$227.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.00 / $49.50 / $73.76	Professional	26	$31.00	$49.50	$73.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.23 / $112.50 / $167.50	Professional	TC	$75.23	$112.50	$167.50
United Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $96.59 / $231.83	Professional		$58.49	$96.59	$231.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $33.97 / $82.06	Professional	26	$14.32	$33.97	$82.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.61 / $80.40 / $147.40	Professional	TC	$43.61	$80.40	$147.40