Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.85 / $36.96 / $36.96	Facility	26	$26.85	$36.96	$36.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $33.65 / $71.23	Professional		$27.41	$33.65	$71.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $9.40 / $35.69	Professional	26	$7.95	$9.40	$35.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $24.25 / $41.59	Professional	TC	$19.46	$24.25	$41.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $83.71 / $87.78	Professional		$36.57	$83.71	$87.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $28.66 / $31.67	Professional	26	$13.26	$28.66	$31.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $52.04 / $59.12	Professional	TC	$23.32	$52.04	$59.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $69.87 / $151.25	Professional		$44.64	$69.87	$151.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $25.29 / $73.97	Professional	26	$21.03	$25.29	$73.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.25 / $44.64 / $88.66	Professional	TC	$34.25	$44.64	$88.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $112.50 / $174.33	Professional		$90.00	$112.50	$174.33
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $37.70 / $58.11	Professional	26	$32.50	$37.70	$58.11
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.50 / $76.70 / $120.00	Professional	TC	$57.50	$76.70	$120.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $90.00 / $174.33	Professional		$33.54	$90.00	$174.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $39.00 / $59.02	Professional	26	$28.00	$39.00	$59.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $54.00 / $78.00 / $120.00	Professional	TC	$54.00	$78.00	$120.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $73.26 / $247.00	Professional		$40.33	$73.26	$247.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $25.34 / $54.48	Professional	26	$11.94	$25.34	$54.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.66 / $47.96 / $162.00	Professional	TC	$28.66	$47.96	$162.00