Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $53.70 / $102.33	Professional		$48.98	$53.70	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.88 / $67.61	Professional	26	$27.54	$33.88	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.38 / $34.67	Professional	TC	$19.05	$21.38	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	TC	$19.50	$19.50	$19.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $144.54 / $269.15	Professional		$43.65	$144.54	$269.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $81.28 / $95.50	Professional	26	$28.84	$81.28	$95.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $42.66 / $47.86	Professional	TC	$15.49	$42.66	$47.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $239.88 / $309.03	Professional		$72.44	$239.88	$309.03
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $154.88 / $190.55	Professional	26	$47.86	$154.88	$190.55
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $85.11 / $120.23	Professional	TC	$23.99	$85.11	$120.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	TC	$19.50	$19.50	$19.50
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $144.54 / $218.78	Professional		$57.54	$144.54	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $102.33 / $154.88	Professional	26	$37.15	$102.33	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $43.65 / $64.57	Professional	TC	$19.50	$43.65	$64.57