Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $36.93 / $36.93	Facility	26	$36.93	$36.93	$36.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $49.57 / $131.57	Professional		$40.39	$49.57	$131.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.97 / $40.67	Professional	26	$9.41	$10.97	$40.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $38.59 / $90.90	Professional	TC	$30.98	$38.59	$90.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.28 / $120.72 / $158.29	Professional		$67.28	$120.72	$158.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.66 / $33.58 / $43.51	Professional	26	$17.66	$33.58	$43.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.62 / $86.34 / $117.67	Professional	TC	$49.62	$86.34	$117.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $130.02 / $277.97	Professional		$107.35	$130.02	$277.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $34.81 / $101.79	Professional	26	$28.30	$34.81	$101.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.81 / $96.06 / $226.72	Professional	TC	$75.81	$96.06	$226.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $180.90 / $270.44	Professional		$140.00	$180.90	$270.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $47.25 / $77.50	Professional	26	$38.75	$47.25	$77.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.25 / $133.65 / $192.21	Professional	TC	$101.25	$133.65	$192.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.80 / $140.00 / $257.02	Professional		$57.80	$140.00	$257.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.00 / $52.50 / $77.50	Professional	26	$31.00	$52.50	$77.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $87.14 / $129.00 / $192.21	Professional	TC	$87.14	$129.00	$192.21
United Facility/Professional Professional Modifier Low / Median / High Price $69.14 / $140.91 / $261.14	Professional		$69.14	$140.91	$261.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $36.22 / $84.43	Professional	26	$14.34	$36.22	$84.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.25 / $69.08 / $148.52	Professional	TC	$54.25	$69.08	$148.52