Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.23 / $102.20 / $102.20	Facility	26	$74.23	$102.20	$102.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $54.54 / $146.15	Professional		$41.75	$54.54	$146.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $27.06 / $87.25	Professional	26	$21.37	$27.06	$87.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $27.47 / $62.17	Professional	TC	$20.39	$27.47	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $77.27 / $149.13	Professional		$49.80	$77.27	$149.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.36 / $46.02 / $88.03	Professional	26	$26.36	$46.02	$88.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.26 / $61.12	Professional	TC	$23.44	$31.26	$61.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $128.10 / $272.55	Professional		$80.70	$128.10	$272.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.60 / $67.92 / $158.97	Professional	26	$56.60	$67.92	$158.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.50 / $60.15 / $123.75	Professional	TC	$49.50	$60.15	$123.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $191.40 / $274.00	Professional		$165.00	$191.40	$274.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.50 / $101.50 / $146.00	Professional	26	$87.50	$101.50	$146.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.50 / $89.90 / $128.00	Professional	TC	$77.50	$89.90	$128.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.97 / $138.36 / $264.00	Professional		$57.97	$138.36	$264.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.83 / $106.50 / $161.16	Professional	26	$51.83	$106.50	$161.16
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $43.31 / $91.50 / $143.35	Professional	TC	$43.31	$91.50	$143.35
United Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $149.15 / $253.56	Professional		$65.84	$149.15	$253.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.96 / $88.03 / $149.65	Professional	26	$33.96	$88.03	$149.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.59 / $64.00 / $103.91	Professional	TC	$38.59	$64.00	$103.91