Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $45.71 / $53.70	Facility	26	$39.81	$45.71	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $70.79 / $208.93	Professional		$37.15	$70.79	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.62 / $53.70	Professional	26	$10.96	$18.62	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $46.77 / $109.65	Professional	TC	$26.92	$46.77	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $190.55	Professional		$107.15	$134.90	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $44.67 / $48.98	Professional	26	$28.84	$44.67	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $100.00 / $147.91	Professional	TC	$87.10	$100.00	$147.91
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $45.71 / $95.50	Facility	26	$39.81	$45.71	$95.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $144.54 / $213.80	Professional		$66.07	$144.54	$213.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $38.02 / $67.61	Professional	26	$16.98	$38.02	$67.61
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $107.15 / $154.88	Professional	TC	$53.70	$107.15	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $309.03	Professional		$177.83	$208.93	$309.03
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $58.88 / $91.20	Professional	26	$47.86	$58.88	$91.20
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $162.18 / $223.87	Professional	TC	$120.23	$162.18	$223.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $107.15 / $138.04	Professional		$47.86	$107.15	$138.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $28.84 / $48.98	Professional	26	$10.72	$28.84	$48.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $46.77 / $107.15	Professional	TC	$33.11	$46.77	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $269.15	Professional		$117.49	$131.83	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $43.65 / $93.33	Professional	26	$31.62	$43.65	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $93.33 / $169.82	Professional	TC	$74.13	$93.33	$169.82