Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $32.29 / $32.29	Facility		$32.29	$32.29	$32.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.38 / $23.38 / $23.38	Facility	26	$23.38	$23.38	$23.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.15 / $14.59 / $35.59	Professional		$12.15	$14.59	$35.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $9.71 / $25.76	Professional	26	$8.25	$9.71	$25.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $4.88 / $9.83	Professional	TC	$3.89	$4.88	$9.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $107.42 / $107.42	Facility		$107.42	$107.42	$107.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $24.25 / $39.35	Professional		$14.04	$24.25	$39.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $17.35 / $27.61	Professional	26	$10.02	$17.35	$27.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.01 / $7.55 / $12.74	Professional	TC	$4.01	$7.55	$12.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $13.47 / $35.59 / $50.89	Facility		$13.47	$35.59	$50.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $31.90 / $68.83	Professional		$22.32	$31.90	$68.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $22.32 / $50.00	Professional	26	$18.60	$22.32	$50.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $8.90 / $10.68 / $18.84	Professional	TC	$8.90	$10.68	$18.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $51.00 / $77.00	Professional		$42.50	$51.00	$77.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.75 / $36.40 / $55.48	Professional	26	$28.75	$36.40	$55.48
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.75 / $18.20 / $26.53	Professional	TC	$13.75	$18.20	$26.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $13.47 / $35.59 / $50.89	Facility		$13.47	$35.59	$50.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.58 / $39.13 / $77.00	Professional		$15.58	$39.13	$77.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.03 / $36.40 / $56.00	Professional	26	$18.03	$36.40	$56.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.68 / $17.93 / $32.00	Professional	TC	$10.68	$17.93	$32.00
United Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $42.99 / $65.11	Professional		$16.32	$42.99	$65.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $27.63 / $46.96	Professional	26	$12.08	$27.63	$46.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.53 / $10.67 / $18.14	Professional	TC	$3.53	$10.67	$18.14