Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $35.36 / $35.36	Facility	26	$25.70	$35.36	$35.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $37.53 / $125.72	Professional		$30.51	$37.53	$125.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $9.78 / $34.31	Professional	26	$8.25	$9.78	$34.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.74 / $90.10	Professional	TC	$22.26	$27.74	$90.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.40 / $97.97 / $144.19	Professional		$60.40	$97.97	$144.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $28.94 / $30.32	Professional	26	$12.77	$28.94	$30.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.64 / $68.45 / $115.26	Professional	TC	$47.64	$68.45	$115.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $96.38 / $116.46 / $243.93	Professional		$96.38	$116.46	$243.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $24.27 / $68.45	Professional	26	$20.23	$24.27	$68.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.08 / $92.19 / $219.83	Professional	TC	$71.08	$92.19	$219.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $162.00 / $243.62	Professional		$131.25	$162.00	$243.62
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $36.25 / $55.88	Professional	26	$31.25	$36.25	$55.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $129.60 / $187.74	Professional	TC	$100.00	$129.60	$187.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $131.25 / $235.00	Professional		$51.96	$131.25	$235.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $37.50 / $56.75	Professional	26	$28.00	$37.50	$56.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.84 / $126.00 / $187.74	Professional	TC	$75.84	$126.00	$187.74
United Facility/Professional Professional Modifier Low / Median / High Price $40.63 / $103.09 / $230.57	Professional		$40.63	$103.09	$230.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $36.33 / $60.99	Professional	26	$11.94	$36.33	$60.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $70.18 / $167.31	Professional	TC	$30.32	$70.18	$167.31