Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $64.57 / $74.13	Facility	26	$46.77	$64.57	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $57.54 / $128.82	Professional		$37.15	$57.54	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $17.38 / $52.48	Professional	26	$7.41	$17.38	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.02 / $114.82	Professional	TC	$28.84	$38.02	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $154.88	Professional		$91.20	$128.82	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $26.92 / $53.70	Professional	26	$15.85	$26.92	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $104.71 / $109.65	Professional	TC	$74.13	$104.71	$109.65
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $74.13	Facility	26	$64.57	$64.57	$74.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $117.49 / $181.97	Professional		$74.13	$117.49	$181.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $45.71 / $104.71	Professional	26	$17.38	$45.71	$104.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $77.62 / $138.04	Professional	TC	$54.95	$77.62	$138.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $302.00	Professional		$165.96	$173.78	$302.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $58.88 / $87.10	Professional	26	$35.48	$58.88	$87.10
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $123.03 / $218.78	Professional	TC	$112.20	$123.03	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $95.50 / $125.89	Professional		$44.67	$95.50	$125.89
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $53.70	Professional	26	$12.88	$20.89	$53.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $109.65	Professional	TC	$25.70	$42.66	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $309.03	Professional		$102.33	$120.23	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $42.66 / $91.20	Professional	26	$23.99	$42.66	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $213.80	Professional	TC	$58.88	$89.13	$213.80