Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $127.15 / $133.50	Professional		$56.17	$127.15	$133.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.93 / $97.18 / $97.18	Professional	26	$42.93	$97.18	$97.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.25 / $29.97 / $29.97	Professional	TC	$13.25	$29.97	$29.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $34.44 / $34.44	Professional		$34.44	$34.44	$34.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $26.90 / $26.90	Professional	26	$26.90	$26.90	$26.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $7.53 / $7.53 / $7.53	Professional	TC	$7.53	$7.53	$7.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $78.81 / $155.75	Professional		$78.81	$78.81	$155.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.25 / $59.25 / $59.25	Professional	26	$59.25	$59.25	$59.25
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $19.54 / $19.54	Professional	TC	$19.54	$19.54	$19.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.13 / $111.25 / $162.87	Professional		$39.13	$111.25	$162.87
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $78.75 / $115.29	Professional	26	$29.23	$78.75	$115.29
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.90 / $31.50 / $47.58	Professional	TC	$9.90	$31.50	$47.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $110.00 / $160.94	Professional		$34.44	$110.00	$160.94
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $78.75 / $120.25	Professional	26	$26.90	$78.75	$120.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $7.53 / $31.25 / $40.70	Professional	TC	$7.53	$31.25	$40.70
United Facility/Professional Professional Modifier Low / Median / High Price $118.56 / $118.56 / $118.56	Professional		$118.56	$118.56	$118.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.35 / $94.35 / $94.35	Professional	26	$94.35	$94.35	$94.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.96 / $13.96 / $24.21	Professional	TC	$13.96	$13.96	$24.21