Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	26	$29.46	$29.46	$29.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $80.69 / $94.36	Professional		$42.64	$80.69	$94.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.31 / $41.92	Professional	26	$8.83	$10.31	$41.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.43 / $56.50 / $70.37	Professional	TC	$52.43	$56.50	$70.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.03 / $52.78 / $80.09	Professional		$39.03	$52.78	$80.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $30.34 / $34.72	Professional	26	$14.23	$30.34	$34.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.80 / $36.90 / $126.20	Professional	TC	$24.80	$36.90	$126.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.28 / $74.73 / $159.34	Professional		$62.28	$74.73	$159.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $27.77 / $68.75	Professional	26	$22.65	$27.77	$68.75
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.51 / $47.55 / $90.64	Professional	TC	$36.51	$47.55	$90.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $102.00 / $145.28	Professional		$81.25	$102.00	$145.28
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $39.20 / $63.00	Professional	26	$35.00	$39.20	$63.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.10 / $63.45 / $85.75	Professional	TC	$48.10	$63.45	$85.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.34 / $84.50 / $145.28	Professional		$35.34	$84.50	$145.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $42.00 / $62.58	Professional	26	$28.00	$42.00	$62.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $46.25 / $58.75 / $86.83	Professional	TC	$46.25	$58.75	$86.83
United Facility/Professional Professional Modifier Low / Median / High Price $57.30 / $86.44 / $212.70	Professional		$57.30	$86.44	$212.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.35 / $41.61 / $80.00	Professional	26	$14.35	$41.61	$80.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.52 / $44.53 / $147.41	Professional	TC	$29.52	$44.53	$147.41