Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $57.54 / $173.78	Professional		$30.90	$57.54	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $37.15	Professional	26	$7.94	$14.13	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $41.69 / $83.18	Professional	TC	$21.88	$41.69	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $147.91	Professional		$85.11	$114.82	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $36.31 / $39.81	Professional	26	$20.89	$36.31	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $112.20	Professional	TC	$79.43	$79.43	$112.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $173.78	Professional		$66.07	$117.49	$173.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $32.36 / $51.29	Professional	26	$17.38	$32.36	$51.29
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $83.18 / $120.23	Professional	TC	$50.12	$83.18	$120.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $245.47	Professional		$147.91	$165.96	$245.47
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $43.65 / $70.79	Professional	26	$39.81	$43.65	$70.79
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $120.23 / $177.83	Professional	TC	$107.15	$120.23	$177.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $85.11 / $114.82	Professional		$39.81	$85.11	$114.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $20.89 / $39.81	Professional	26	$9.12	$20.89	$39.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $42.66 / $83.18	Professional	TC	$27.54	$42.66	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $104.71 / $239.88	Professional		$95.50	$104.71	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.11 / $79.43	Professional	26	$27.54	$33.11	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $77.62 / $158.49	Professional	TC	$63.10	$77.62	$158.49