Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.77 / $37.77 / $37.77	Facility	26	$37.77	$37.77	$37.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $46.60 / $150.51	Professional		$37.92	$46.60	$150.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $11.49 / $49.57	Professional	26	$9.75	$11.49	$49.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $35.11 / $84.38	Professional	TC	$28.17	$35.11	$84.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $118.03 / $149.84	Professional		$63.31	$118.03	$149.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $34.29 / $44.52	Professional	26	$18.16	$34.29	$44.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.15 / $78.27 / $108.03	Professional	TC	$45.15	$78.27	$108.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $122.28 / $264.33	Professional		$72.78	$122.28	$264.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $35.60 / $104.07	Professional	26	$29.10	$35.60	$104.07
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $87.33 / $208.33	Professional	TC	$68.88	$87.33	$208.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $171.45 / $254.79	Professional		$140.00	$171.45	$254.79
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $48.60 / $77.50	Professional	26	$38.75	$48.60	$77.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.25 / $122.85 / $174.33	Professional	TC	$101.25	$122.85	$174.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.72 / $140.00 / $251.45	Professional		$54.72	$140.00	$251.45
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.00 / $54.00 / $77.50	Professional	26	$33.00	$54.00	$77.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $83.74 / $117.00 / $174.33	Professional	TC	$83.74	$117.00	$174.33
United Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $98.22 / $216.00	Professional		$54.18	$98.22	$216.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $44.53 / $83.66	Professional	26	$14.41	$44.53	$83.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.33 / $91.26 / $157.37	Professional	TC	$40.33	$91.26	$157.37