Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.01 / $38.54 / $38.54	Facility	26	$28.01	$38.54	$38.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $70.01 / $228.05 / $436.15	Facility	TC	$70.01	$228.05	$436.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $31.40 / $109.38	Professional		$26.78	$31.40	$109.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $9.72 / $34.69	Professional	26	$8.46	$9.72	$34.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $21.68 / $83.35	Professional	TC	$18.32	$21.68	$83.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.46 / $76.03 / $115.16	Professional		$50.46	$76.03	$115.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.74 / $28.81 / $33.03	Professional	26	$13.74	$28.81	$33.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.72 / $47.23 / $83.90	Professional	TC	$36.72	$47.23	$83.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.73 / $97.05 / $204.55	Professional		$79.73	$97.05	$204.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.83 / $26.37 / $77.16	Professional	26	$21.83	$26.37	$77.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.55 / $70.83 / $164.58	Professional	TC	$54.55	$70.83	$164.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.75 / $135.00 / $198.92	Professional		$108.75	$135.00	$198.92
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $39.15 / $60.35	Professional	26	$33.75	$39.15	$60.35
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $98.55 / $138.57	Professional	TC	$75.00	$98.55	$138.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $108.75 / $194.23	Professional		$42.64	$108.75	$194.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.00 / $40.50 / $61.29	Professional	26	$27.00	$40.50	$61.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $93.00 / $138.57	Professional	TC	$56.00	$93.00	$138.57
United Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $85.06 / $191.35	Professional		$45.24	$85.06	$191.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $26.42 / $66.42	Professional	26	$14.32	$26.42	$66.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.69 / $61.86 / $124.93	Professional	TC	$31.69	$61.86	$124.93