Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $23.99 / $23.99	Facility	26	$23.99	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $12.88 / $33.11	Professional		$9.55	$12.88	$33.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.94 / $23.99	Professional	26	$6.03	$7.94	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $3.98 / $9.12	Professional	TC	$2.88	$3.98	$9.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $22.91 / $39.81	Professional		$14.13	$22.91	$39.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $27.54	Professional	26	$10.00	$15.85	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $7.24 / $13.18	Professional	TC	$2.69	$7.24	$13.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $20.42 / $36.31	Facility		$12.59	$20.42	$36.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $33.88 / $52.48	Professional		$17.78	$33.88	$52.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $22.91 / $38.02	Professional	26	$10.72	$22.91	$38.02
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $11.75 / $15.49	Professional	TC	$6.31	$11.75	$15.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $51.29 / $77.62	Professional		$44.67	$51.29	$77.62
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.11 / $51.29	Professional	26	$28.84	$33.11	$51.29
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $16.60 / $26.30	Professional	TC	$14.79	$16.60	$26.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $19.05 / $36.31	Facility		$9.55	$19.05	$36.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $20.89 / $38.02	Professional		$12.02	$20.89	$38.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $29.51	Professional	26	$7.41	$11.75	$29.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.55 / $5.89 / $13.80	Professional	TC	$3.55	$5.89	$13.80
United Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $42.66 / $64.57	Professional		$13.49	$42.66	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $28.18 / $46.77	Professional	26	$9.12	$28.18	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $12.88 / $19.05	Professional	TC	$4.07	$12.88	$19.05