Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.01 / $66.08 / $98.56	Facility	26	$48.01	$66.08	$98.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.64 / $53.26 / $149.37	Professional		$43.64	$53.26	$149.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.82 / $62.07	Professional	26	$13.58	$15.82	$62.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.03 / $37.43 / $109.04	Professional	TC	$30.03	$37.43	$109.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $135.19 / $177.28	Professional		$75.65	$135.19	$177.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $48.91 / $56.01	Professional	26	$23.55	$48.91	$56.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.10 / $86.29 / $124.91	Professional	TC	$52.10	$86.29	$124.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $145.56 / $313.50	Professional		$100.92	$145.56	$313.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.88 / $48.36 / $130.00	Professional	26	$39.88	$48.36	$130.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.84 / $100.92 / $240.57	Professional	TC	$77.84	$100.92	$240.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.75 / $202.50 / $303.95	Professional		$163.75	$202.50	$303.95
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $66.70 / $100.58	Professional	26	$57.50	$66.70	$100.58
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.25 / $141.75 / $202.80	Professional	TC	$106.25	$141.75	$202.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.44 / $163.75 / $293.75	Professional		$64.44	$163.75	$293.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.31 / $67.50 / $102.15	Professional	26	$45.31	$67.50	$102.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $91.38 / $136.50 / $200.98	Professional	TC	$91.38	$136.50	$200.98
United Facility/Professional Professional Modifier Low / Median / High Price $66.33 / $163.92 / $296.43	Professional		$66.33	$163.92	$296.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $46.62 / $112.62	Professional	26	$21.23	$46.62	$112.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.84 / $76.06 / $176.16	Professional	TC	$32.84	$76.06	$176.16