Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.86 / $34.21 / $55.50	Facility	26	$24.86	$34.21	$55.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $38.75 / $125.36	Professional		$25.87	$38.75	$125.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $12.48 / $44.88	Professional	26	$7.03	$12.48	$44.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $29.38 / $82.72	Professional	TC	$18.82	$29.38	$82.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.48 / $79.59 / $114.04	Professional		$49.48	$79.59	$114.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $25.57 / $29.31	Professional	26	$12.27	$25.57	$29.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $54.02 / $86.31	Professional	TC	$37.21	$54.02	$86.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.66 / $95.10 / $223.25	Professional		$77.66	$95.10	$223.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $23.40 / $68.45	Professional	26	$19.39	$23.40	$68.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.30 / $71.81 / $169.20	Professional	TC	$55.30	$71.81	$169.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.50 / $132.30 / $196.68	Professional		$102.50	$132.30	$196.68
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $34.79 / $53.64	Professional	26	$30.00	$34.79	$53.64
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.50 / $99.90 / $140.40	Professional	TC	$72.50	$99.90	$140.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $102.50 / $185.52	Professional		$42.28	$102.50	$185.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $36.00 / $54.48	Professional	26	$24.00	$36.00	$54.48
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $96.00 / $139.13	Professional	TC	$59.00	$96.00	$139.13
United Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $93.45 / $187.94	Professional		$41.29	$93.45	$187.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $24.40 / $58.93	Professional	26	$10.88	$24.40	$58.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.41 / $62.73 / $120.83	Professional	TC	$30.41	$62.73	$120.83