Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $28.18 / $33.11	Facility	26	$24.55	$28.18	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $39.81 / $120.23	Professional		$20.89	$39.81	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $30.20	Professional	26	$6.03	$10.00	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.70 / $57.54	Professional	TC	$15.14	$25.70	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $102.33	Professional		$57.54	$79.43	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $24.55 / $28.18	Professional	26	$14.79	$24.55	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $56.23 / $75.86	Professional	TC	$53.70	$56.23	$75.86
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $26.30 / $45.71	Facility	26	$24.55	$26.30	$45.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $72.44 / $114.82	Professional		$35.48	$72.44	$114.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $23.44 / $43.65	Professional	26	$10.72	$23.44	$43.65
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	50	$158.49	$158.49	$158.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $54.95 / $79.43	Professional	TC	$28.18	$54.95	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $177.83	Professional		$95.50	$114.82	$177.83
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $30.90 / $51.29	Professional	26	$28.84	$30.90	$51.29
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $125.89	Professional	TC	$66.07	$85.11	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $56.23 / $79.43	Professional		$25.70	$56.23	$79.43
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $14.79 / $28.18	Professional	26	$6.46	$14.79	$28.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $58.88	Professional	TC	$17.78	$25.12	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $147.91	Professional		$66.07	$74.13	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.44 / $58.88	Professional	26	$19.95	$23.44	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $95.50	Professional	TC	$42.66	$52.48	$95.50