Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.30 / $30.30 / $41.72	Facility	26	$30.30	$30.30	$41.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $31.36 / $93.53	Professional		$25.76	$31.36	$93.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $9.81 / $33.38	Professional	26	$8.48	$9.81	$33.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $21.54 / $61.36	Professional	TC	$17.28	$21.54	$61.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $78.26 / $109.05	Professional		$48.46	$78.26	$109.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $33.59 / $35.72	Professional	26	$14.23	$33.59	$35.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.24 / $43.83 / $75.45	Professional	TC	$34.24	$43.83	$75.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $93.15 / $198.28	Professional		$77.63	$93.15	$198.28
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 $51.96 / $66.00 / $153.13	Professional	TC	$51.96	$66.00	$153.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.50 / $129.60 / $200.00	Professional		$117.50	$129.60	$200.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $40.29 / $64.81	Professional	26	$35.00	$40.29	$64.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.25 / $91.80 / $124.44	Professional	TC	$81.25	$91.80	$124.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $102.70 / $182.80	Professional		$43.98	$102.70	$182.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.00 / $43.50 / $65.83	Professional	26	$31.00	$43.50	$65.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $49.77 / $93.00 / $122.50	Professional	TC	$49.77	$93.00	$122.50
United Facility/Professional Professional Modifier Low / Median / High Price $32.84 / $80.75 / $176.82	Professional		$32.84	$80.75	$176.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $30.70 / $64.56	Professional	26	$14.40	$30.70	$64.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.11 / $55.83 / $112.26	Professional	TC	$39.11	$55.83	$112.26