Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.78 / $46.48 / $46.48	Facility	26	$33.78	$46.48	$46.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $38.51 / $126.27	Professional		$31.42	$38.51	$126.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $9.60 / $40.15	Professional	26	$8.22	$9.60	$40.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $28.90 / $79.72	Professional	TC	$23.19	$28.90	$79.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $95.06 / $139.07	Professional		$59.36	$95.06	$139.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $29.15 / $40.79	Professional	26	$16.19	$29.15	$40.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.17 / $65.91 / $101.99	Professional	TC	$43.17	$65.91	$101.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.43 / $114.51 / $245.30	Professional		$95.43	$114.51	$245.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $31.84 / $93.08	Professional	26	$25.88	$31.84	$93.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.80 / $83.46 / $196.82	Professional	TC	$65.80	$83.46	$196.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $159.30 / $239.15	Professional		$122.50	$159.30	$239.15
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $43.20 / $67.50	Professional	26	$33.75	$43.20	$67.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.75 / $116.10 / $165.39	Professional	TC	$88.75	$116.10	$165.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $122.50 / $221.34	Professional		$50.83	$122.50	$221.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.00 / $49.50 / $67.50	Professional	26	$27.00	$49.50	$67.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $73.00 / $111.00 / $165.00	Professional	TC	$73.00	$111.00	$165.00
United Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $95.74 / $218.46	Professional		$38.61	$95.74	$218.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.89 / $32.64 / $73.31	Professional	26	$12.89	$32.64	$73.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.61 / $73.91 / $145.13	Professional	TC	$36.61	$73.91	$145.13