Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.18 / $127.15 / $133.50	Professional		$56.18	$127.15	$133.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $31.82 / $257.56	Professional	26	$13.39	$31.82	$257.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.79 / $96.84 / $96.84	Professional	TC	$42.79	$96.84	$96.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $49.22 / $49.22	Professional		$49.22	$49.22	$49.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $9.08 / $9.08	Professional	26	$9.08	$9.08	$9.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.14 / $40.14 / $40.14	Professional	TC	$40.14	$40.14	$40.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.28 / $172.66 / $175.00	Professional		$78.28	$172.66	$175.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $18.48 / $18.48	Professional	26	$18.48	$18.48	$18.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.79 / $59.79 / $59.79	Professional	TC	$59.79	$59.79	$59.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $125.00 / $183.00	Professional		$39.61	$125.00	$183.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $25.00 / $36.60	Professional	26	$9.43	$25.00	$36.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.18 / $100.00 / $146.40	Professional	TC	$30.18	$100.00	$146.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $125.00 / $162.80	Professional		$49.22	$125.00	$162.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $25.00 / $38.85	Professional	26	$9.08	$25.00	$38.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.14 / $100.00 / $123.95	Professional	TC	$40.14	$100.00	$123.95
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $109.71 / $109.71	Professional		$109.71	$109.71	$109.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $19.39 / $29.10	Professional	26	$10.74	$19.39	$29.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.61 / $80.61 / $80.61	Professional	TC	$80.61	$80.61	$80.61