Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $38.90 / $46.77	Facility	26	$34.67	$38.90	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $48.98 / $162.18	Professional		$28.18	$48.98	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.80 / $37.15	Professional	26	$7.94	$13.80	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.88 / $79.43	Professional	TC	$19.95	$33.88	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $144.54	Professional		$79.43	$95.50	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $28.84 / $40.74	Professional	26	$17.38	$28.84	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $74.13 / $107.15	Professional	TC	$66.07	$74.13	$107.15
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $38.90 / $46.77	Facility	26	$37.15	$38.90	$46.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $104.71 / $162.18	Professional		$48.98	$104.71	$162.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $30.90 / $50.12	Professional	26	$13.49	$30.90	$50.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $75.86 / $107.15	Professional	TC	$36.31	$75.86	$107.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $229.09	Professional		$120.23	$158.49	$229.09
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.65 / $63.10	Professional	26	$33.88	$43.65	$63.10
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $114.82 / $165.96	Professional	TC	$85.11	$114.82	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $74.13 / $104.71	Professional		$35.48	$74.13	$104.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.38 / $40.74	Professional	26	$8.91	$17.38	$40.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $79.43	Professional	TC	$23.44	$33.88	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $213.80	Professional		$79.43	$95.50	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $74.13	Professional	26	$26.92	$33.88	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $66.07 / $128.82	Professional	TC	$52.48	$66.07	$128.82