Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $32.36 / $38.90	Facility	26	$28.84	$32.36	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $85.11	Professional		$26.92	$38.90	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $37.15	Professional	26	$7.08	$12.02	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $54.95	Professional	TC	$19.05	$25.70	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $109.65	Professional		$61.66	$93.33	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $31.62 / $33.11	Professional	26	$19.50	$31.62	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $77.62	Professional	TC	$61.66	$74.13	$77.62
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $32.36 / $38.90	Facility	26	$30.90	$32.36	$38.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $81.28 / $125.89	Professional		$41.69	$81.28	$125.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $28.18 / $44.67	Professional	26	$15.49	$28.18	$44.67
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	52	$53.70	$53.70	$53.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $56.23 / $79.43	Professional	TC	$34.67	$56.23	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $208.93	Professional		$114.82	$131.83	$208.93
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.90 / $64.57	Professional	26	$34.67	$38.90	$64.57
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $93.33 / $144.54	Professional	TC	$81.28	$93.33	$144.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $70.79 / $85.11	Professional		$34.67	$70.79	$85.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $19.50 / $33.11	Professional	26	$7.76	$19.50	$33.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $35.48 / $77.62	Professional	TC	$18.62	$35.48	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $190.55	Professional		$74.13	$87.10	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $66.07	Professional	26	$23.44	$29.51	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $56.23 / $117.49	Professional	TC	$48.98	$56.23	$117.49