Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.93 / $38.93 / $77.95	Facility	26	$38.93	$38.93	$77.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $41.11 / $139.24	Professional		$35.09	$41.11	$139.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $13.60 / $50.95	Professional	26	$11.82	$13.60	$50.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $27.51 / $84.38	Professional	TC	$23.26	$27.51	$84.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.79 / $100.54 / $151.00	Professional		$64.79	$100.54	$151.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $40.58 / $46.88	Professional	26	$18.64	$40.58	$46.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.15 / $59.96 / $108.03	Professional	TC	$46.15	$59.96	$108.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $103.89 / $125.19 / $267.02	Professional		$103.89	$125.19	$267.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.93 / $36.68 / $107.25	Professional	26	$29.93	$36.68	$107.25
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.42 / $89.28 / $208.33	Professional	TC	$70.42	$89.28	$208.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.50 / $174.15 / $261.50	Professional		$142.50	$174.15	$261.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.25 / $50.70 / $84.93	Professional	26	$46.25	$50.70	$84.93
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.75 / $124.20 / $176.57	Professional	TC	$93.75	$124.20	$176.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.13 / $142.50 / $249.07	Professional		$55.13	$142.50	$249.07
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.00 / $57.00 / $84.93	Professional	26	$38.00	$57.00	$84.93
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $71.09 / $118.50 / $176.57	Professional	TC	$71.09	$118.50	$176.57
United Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $100.92 / $216.98	Professional		$59.14	$100.92	$216.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $56.25 / $94.27	Professional	26	$20.16	$56.25	$94.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.67 / $78.19 / $156.19	Professional	TC	$37.67	$78.19	$156.19