Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $29.51 / $54.95	Professional		$26.30	$29.51	$54.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $22.91 / $41.69	Professional	26	$19.95	$22.91	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.61 / $7.41 / $13.18	Professional	TC	$6.61	$7.41	$13.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	26	$26.92	$26.92	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $7.59 / $7.59 / $7.59	Professional	TC	$7.59	$7.59	$7.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $134.90	Professional		$52.48	$79.43	$134.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $58.88 / $102.33	Professional	26	$26.30	$58.88	$102.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $19.95 / $31.62	Professional	TC	$10.72	$19.95	$31.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $125.89 / $162.18	Professional		$38.90	$125.89	$162.18
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $95.50 / $114.82	Professional	26	$29.51	$95.50	$114.82
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $31.62 / $47.86	Professional	TC	$10.00	$31.62	$47.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	26	$26.92	$26.92	$26.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $7.59 / $7.59 / $7.59	Professional	TC	$7.59	$7.59	$7.59
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $79.43 / $117.49	Professional		$30.20	$79.43	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $63.10 / $93.33	Professional	26	$22.91	$63.10	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $7.24 / $16.22 / $23.99	Professional	TC	$7.24	$16.22	$23.99