Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.46 / $40.56 / $82.81	Facility	26	$29.46	$40.56	$82.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.39 / $107.69 / $184.65	Professional		$66.39	$107.69	$184.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $10.92 / $40.56	Professional	26	$9.40	$10.92	$40.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.90 / $79.72 / $105.23	Professional	TC	$51.90	$79.72	$105.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.38 / $118.03 / $131.91	Professional		$59.38	$118.03	$131.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $31.19 / $34.72	Professional	26	$14.23	$31.19	$34.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.15 / $83.31 / $100.72	Professional	TC	$45.15	$83.31	$100.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.85 / $114.51 / $284.95	Professional		$93.85	$114.51	$284.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $27.77 / $81.25	Professional	26	$22.65	$27.77	$81.25
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $87.33 / $203.71	Professional	TC	$68.88	$87.33	$203.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $159.30 / $248.09	Professional		$141.25	$159.30	$248.09
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $40.60 / $62.58	Professional	26	$35.00	$40.60	$62.58
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.00 / $121.50 / $185.51	Professional	TC	$109.00	$121.50	$185.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $136.80 / $248.09	Professional		$53.47	$136.80	$248.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $42.00 / $63.56	Professional	26	$29.00	$42.00	$63.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $100.72 / $124.50 / $186.14	Professional	TC	$100.72	$124.50	$186.14
United Facility/Professional Professional Modifier Low / Median / High Price $94.42 / $118.03 / $213.28	Professional		$94.42	$118.03	$213.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $28.91 / $62.75	Professional	26	$14.34	$28.91	$62.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.64 / $99.96 / $150.53	Professional	TC	$66.64	$99.96	$150.53