Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $32.81 / $97.18	Professional		$26.78	$32.81	$97.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $27.71	Professional	26	$7.33	$8.55	$27.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $24.25 / $69.47	Professional	TC	$19.46	$24.25	$69.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.97 / $81.63 / $116.41	Professional		$50.97	$81.63	$116.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.76 / $26.76 / $30.66	Professional	26	$12.76	$26.76	$30.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.21 / $54.87 / $88.73	Professional	TC	$38.21	$54.87	$88.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $98.01 / $205.76	Professional		$80.22	$98.01	$205.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $24.50 / $69.36	Professional	26	$20.23	$24.50	$69.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.80 / $73.73 / $173.81	Professional	TC	$56.80	$73.73	$173.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.75 / $136.35 / $201.15	Professional		$108.75	$136.35	$201.15
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $36.00 / $55.88	Professional	26	$31.25	$36.00	$55.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.50 / $102.60 / $144.30	Professional	TC	$77.50	$102.60	$144.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $108.75 / $189.39	Professional		$43.12	$108.75	$189.39
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $37.50 / $55.88	Professional	26	$25.00	$37.50	$55.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $60.00 / $97.50 / $143.01	Professional	TC	$60.00	$97.50	$143.01
United Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $85.06 / $188.21	Professional		$40.86	$85.06	$188.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $25.54 / $61.69	Professional	26	$11.94	$25.54	$61.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.19 / $64.45 / $120.83	Professional	TC	$29.19	$64.45	$120.83