Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.86 / $24.86 / $42.74	Facility	26	$24.86	$24.86	$42.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.78 / $202.53 / $380.19	Facility	TC	$53.78	$202.53	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $29.53 / $86.59	Professional		$25.17	$29.53	$86.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $8.63 / $27.37	Professional	26	$7.50	$8.63	$27.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $20.90 / $59.22	Professional	TC	$17.67	$20.90	$59.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $71.09 / $103.19	Professional		$45.02	$71.09	$103.19
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 $32.75 / $45.53 / $75.45	Professional	TC	$32.75	$45.53	$75.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.89 / $86.37 / $181.61	Professional		$70.89	$86.37	$181.61
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 $49.65 / $63.09 / $146.25	Professional	TC	$49.65	$63.09	$146.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.15 / $183.27	Professional		$100.00	$120.15	$183.27
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 $70.00 / $87.75 / $129.63	Professional	TC	$70.00	$87.75	$129.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $100.00 / $180.52	Professional		$38.00	$100.00	$180.52
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 $54.00 / $87.00 / $129.63	Professional	TC	$54.00	$87.00	$129.63
United Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $75.61 / $185.24	Professional		$42.58	$75.61	$185.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $24.40 / $64.41	Professional	26	$12.03	$24.40	$64.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.66 / $54.99 / $120.83	Professional	TC	$28.66	$54.99	$120.83