Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.93 / $85.79 / $99.12	Facility	26	$36.93	$85.79	$99.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.58 / $360.23 / $390.26	Professional		$92.58	$360.23	$390.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $52.54 / $52.54	Professional	26	$12.35	$52.54	$52.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $307.68 / $342.15	Professional	TC	$80.22	$307.68	$342.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.68 / $385.05 / $700.00	Professional		$149.68	$385.05	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.66 / $38.01 / $43.51	Professional	26	$17.66	$38.01	$43.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.02 / $289.08 / $344.44	Professional	TC	$132.02	$289.08	$344.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $232.14 / $291.12 / $620.62	Professional		$232.14	$291.12	$620.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $34.81 / $86.13	Professional	26	$28.30	$34.81	$86.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.88 / $257.16 / $534.49	Professional	TC	$198.88	$257.16	$534.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $435.00 / $723.60	Professional		$375.00	$435.00	$723.60
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $49.00 / $78.75	Professional	26	$43.75	$49.00	$78.75
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.25 / $375.70 / $641.45	Professional	TC	$331.25	$375.70	$641.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.65 / $387.50 / $700.00	Professional		$137.65	$387.50	$700.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $52.50 / $78.23	Professional	26	$35.00	$52.50	$78.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $303.66 / $430.50 / $641.45	Professional	TC	$303.66	$430.50	$641.45
United Facility/Professional Professional Modifier Low / Median / High Price $226.56 / $399.12 / $618.00	Professional		$226.56	$399.12	$618.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.69 / $52.11 / $83.17	Professional	26	$15.69	$52.11	$83.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.11 / $346.92 / $538.00	Professional	TC	$210.11	$346.92	$538.00