Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.18 / $27.11 / $50.85	Facility	26	$20.18	$27.11	$50.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $67.06 / $348.75 / $455.06	Facility	TC	$67.06	$348.75	$455.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.55 / $48.96 / $119.19	Professional		$26.55	$48.96	$119.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $7.68 / $28.63	Professional	26	$5.53	$7.68	$28.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $27.90 / $96.89	Professional	TC	$21.01	$27.90	$96.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $82.80 / $103.32	Professional		$44.05	$82.80	$103.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $20.29 / $23.23	Professional	26	$9.81	$20.29	$23.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.24 / $60.11 / $81.48	Professional	TC	$34.24	$60.11	$81.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $84.42 / $179.36	Professional		$68.52	$84.42	$179.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $18.55 / $54.28	Professional	26	$15.38	$18.55	$54.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.78 / $66.00 / $133.43	Professional	TC	$50.78	$66.00	$133.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.25 / $118.80 / $180.00	Professional		$101.25	$118.80	$180.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.75 / $27.55 / $42.47	Professional	26	$23.75	$27.55	$42.47
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.50 / $93.15 / $134.10	Professional	TC	$77.50	$93.15	$134.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $101.25 / $176.57	Professional		$38.47	$101.25	$176.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.00 / $28.50 / $43.13	Professional	26	$19.00	$28.50	$43.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $62.51 / $90.00 / $139.38	Professional	TC	$62.51	$90.00	$139.38
United Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $75.61 / $185.19	Professional		$36.61	$75.61	$185.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $23.23 / $51.10	Professional	26	$8.89	$23.23	$51.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $60.12 / $134.09	Professional	TC	$28.13	$60.12	$134.09