Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.08 / $60.68 / $60.68	Facility	26	$44.08	$60.68	$60.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $115.99 / $358.00 / $508.16	Facility	TC	$115.99	$358.00	$508.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $51.88 / $198.77	Professional		$44.27	$51.88	$198.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $15.43 / $60.68	Professional	26	$13.41	$15.43	$60.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.45 / $119.30	Professional	TC	$30.85	$36.45	$119.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.15 / $125.35 / $190.68	Professional		$81.15	$125.35	$190.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $45.86 / $51.95	Professional	26	$21.10	$45.86	$51.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.05 / $79.48 / $141.80	Professional	TC	$60.05	$79.48	$141.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $157.19 / $335.50	Professional		$131.00	$157.19	$335.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $41.54 / $121.42	Professional	26	$33.97	$41.54	$121.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.96 / $116.46 / $275.08	Professional	TC	$91.96	$116.46	$275.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.25 / $218.70 / $326.31	Professional		$176.25	$218.70	$326.31
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.50 / $56.70 / $93.87	Professional	26	$52.50	$56.70	$93.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.50 / $162.00 / $232.44	Professional	TC	$122.50	$162.00	$232.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.01 / $176.25 / $315.33	Professional		$70.01	$176.25	$315.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $63.00 / $95.34	Professional	26	$43.00	$63.00	$95.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $94.00 / $156.00 / $232.44	Professional	TC	$94.00	$156.00	$232.44
United Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $125.16 / $269.08	Professional		$74.77	$125.16	$269.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.82 / $51.95 / $104.48	Professional	26	$22.82	$51.95	$104.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $102.25 / $210.15	Professional	TC	$37.53	$102.25	$210.15