Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.46 / $33.46 / $33.46	Facility	26	$33.46	$33.46	$33.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $57.39 / $167.43	Professional		$46.61	$57.39	$167.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.82 / $36.85	Professional	26	$10.02	$11.82	$36.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.57 / $45.57 / $83.45	Professional	TC	$36.57	$45.57	$83.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.35 / $115.82 / $145.15	Professional		$61.35	$115.82	$145.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $36.33 / $39.45	Professional	26	$16.20	$36.33	$39.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.15 / $79.28 / $108.03	Professional	TC	$45.15	$79.28	$108.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $118.38 / $298.22	Professional		$97.44	$118.38	$298.22
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $31.52 / $92.17	Professional	26	$25.88	$31.52	$92.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $87.33 / $206.05	Professional	TC	$68.88	$87.33	$206.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.25 / $164.70 / $248.09	Professional		$151.25	$164.70	$248.09
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $46.40 / $71.52	Professional	26	$40.00	$46.40	$71.52
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.25 / $121.50 / $176.57	Professional	TC	$111.25	$121.50	$176.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.97 / $146.40 / $248.09	Professional		$55.97	$146.40	$248.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.00 / $48.00 / $72.64	Professional	26	$34.00	$48.00	$72.64
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $79.79 / $118.50 / $189.66	Professional	TC	$79.79	$118.50	$189.66
United Facility/Professional Professional Modifier Low / Median / High Price $67.39 / $104.82 / $238.77	Professional		$67.39	$104.82	$238.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.88 / $31.56 / $79.34	Professional	26	$14.88	$31.56	$79.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.12 / $79.28 / $159.43	Professional	TC	$53.12	$79.28	$159.43