Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.46 / $32.24 / $89.44	Facility	26	$31.46	$32.24	$89.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $41.44 / $134.44	Professional		$32.92	$41.44	$134.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.82 / $41.18	Professional	26	$10.02	$11.82	$41.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $28.52 / $68.54	Professional	TC	$22.87	$28.52	$68.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.42 / $100.54 / $123.48	Professional		$52.42	$100.54	$123.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $34.75 / $38.10	Professional	26	$15.21	$34.75	$38.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $65.06 / $88.73	Professional	TC	$37.21	$65.06	$88.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $59.85 / $100.92 / $216.54	Professional		$59.85	$100.92	$216.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.25 / $29.66 / $86.71	Professional	26	$24.25	$29.66	$86.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.58 / $71.81 / $169.20	Professional	TC	$56.58	$71.81	$169.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.75 / $140.40 / $214.56	Professional		$118.75	$140.40	$214.56
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.50 / $41.60 / $69.29	Professional	26	$37.50	$41.60	$69.29
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.75 / $99.90 / $145.28	Professional	TC	$78.75	$99.90	$145.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $118.75 / $214.56	Professional		$45.13	$118.75	$214.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.00 / $46.50 / $69.29	Professional	26	$34.00	$46.50	$69.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $65.15 / $97.50 / $145.28	Professional	TC	$65.15	$97.50	$145.28
United Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $89.35 / $207.64	Professional		$50.40	$89.35	$207.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $31.72 / $76.62	Professional	26	$14.32	$31.72	$76.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $63.56 / $131.02	Professional	TC	$23.46	$63.56	$131.02