Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $26.30 / $37.15	Professional		$17.78	$26.30	$37.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.44 / $120.23	Professional	26	$12.88	$23.44	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $10.47 / $13.49	Professional	TC	$6.92	$10.47	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $5.50 / $5.50	Professional	TC	$5.50	$5.50	$5.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $27.54 / $29.51	Facility		$17.78	$27.54	$29.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $46.77 / $87.10	Professional		$15.14	$46.77	$87.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $33.11 / $239.88	Professional	26	$9.55	$33.11	$239.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.62 / $16.22 / $30.90	Professional	TC	$5.62	$16.22	$30.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $91.20 / $112.20	Professional		$26.92	$91.20	$112.20
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $53.70 / $66.07	Professional	26	$16.60	$53.70	$66.07
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $37.15 / $45.71	Professional	TC	$10.47	$37.15	$45.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $17.78 / $29.51	Facility		$15.85	$17.78	$29.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $5.50 / $5.50	Professional	TC	$5.50	$5.50	$5.50
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $54.95 / $83.18	Professional		$21.88	$54.95	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $35.48 / $52.48	Professional	26	$12.88	$35.48	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $19.95 / $29.51	Professional	TC	$9.12	$19.95	$29.51