Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.96 / $85.94 / $88.08	Professional		$37.96	$85.94	$88.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.59 / $55.29 / $189.88	Professional	26	$16.59	$55.29	$189.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.54 / $30.65 / $30.65	Professional	TC	$13.54	$30.65	$30.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $21.67 / $21.67	Professional		$21.67	$21.67	$21.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.13 / $16.13 / $16.13	Professional	26	$16.13	$16.13	$16.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.54 / $5.54 / $5.54	Professional	TC	$5.54	$5.54	$5.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $52.18 / $106.75	Professional		$21.00	$52.18	$106.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $33.71 / $33.71	Professional	26	$33.71	$33.71	$33.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	TC	$18.45	$18.45	$18.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $76.25 / $111.63	Professional		$26.88	$76.25	$111.63
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $45.00 / $65.88	Professional	26	$16.50	$45.00	$65.88
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.37 / $31.25 / $45.75	Professional	TC	$10.37	$31.25	$45.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $76.25 / $116.55	Professional		$21.67	$76.25	$116.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.13 / $43.75 / $68.45	Professional	26	$16.13	$43.75	$68.45
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $5.54 / $32.50 / $48.10	Professional	TC	$5.54	$32.50	$48.10
United Facility/Professional Professional Modifier Low / Median / High Price $82.77 / $82.77 / $82.77	Professional		$82.77	$82.77	$82.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $53.01 / $53.01	Professional	26	$53.01	$53.01	$53.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $29.76 / $29.76	Professional	TC	$29.76	$29.76	$29.76