Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.26 / $229.21 / $229.21	Professional		$101.26	$229.21	$229.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.68 / $137.37 / $306.60	Professional	26	$60.68	$137.37	$306.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.58 / $91.84 / $91.84	Professional	TC	$40.58	$91.84	$91.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.76 / $48.76 / $48.76	Professional		$48.76	$48.76	$48.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Professional	26	$39.72	$39.72	$39.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.02 / $9.02 / $9.02	Professional	TC	$9.02	$9.02	$9.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $139.81 / $287.00	Professional		$51.00	$139.81	$287.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.76 / $83.76 / $83.76	Professional	26	$83.76	$83.76	$83.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.05 / $56.05 / $56.05	Professional	TC	$56.05	$56.05	$56.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $205.00 / $300.12	Professional		$57.52	$205.00	$300.12
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.02 / $111.25 / $162.87	Professional	26	$41.02	$111.25	$162.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.50 / $93.75 / $137.25	Professional	TC	$16.50	$93.75	$137.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.76 / $203.75 / $279.35	Professional		$48.76	$203.75	$279.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $110.00 / $168.35	Professional	26	$39.72	$110.00	$168.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $9.02 / $93.75 / $111.00	Professional	TC	$9.02	$93.75	$111.00
United Facility/Professional Professional Modifier Low / Median / High Price $209.82 / $209.82 / $209.82	Professional		$209.82	$209.82	$209.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.84 / $132.84 / $132.84	Professional	26	$132.84	$132.84	$132.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.98 / $76.98 / $76.98	Professional	TC	$76.98	$76.98	$76.98