Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.66 / $87.77	Professional		$37.15	$46.66	$87.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.20 / $20.84 / $46.26	Professional	26	$17.20	$20.84	$46.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.96 / $25.82 / $41.50	Professional	TC	$19.96	$25.82	$41.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $34.40 / $110.22	Professional		$26.70	$34.40	$110.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $15.99 / $59.13	Professional	26	$12.80	$15.99	$59.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.91 / $18.42 / $51.09	Professional	TC	$13.91	$18.42	$51.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.48 / $74.59 / $105.32	Facility		$31.48	$74.59	$105.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.37 / $97.05 / $116.16	Professional		$55.37	$97.05	$116.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.09 / $44.75 / $46.78	Professional	26	$29.09	$44.75	$46.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $44.75 / $51.42	Professional	TC	$26.27	$44.75	$51.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $68.59 / $135.00	Professional		$47.50	$68.59	$135.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $33.84 / $63.45	Professional	26	$23.00	$33.84	$63.45
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.50 / $35.70 / $71.55	Professional	TC	$24.50	$35.70	$71.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.44 / $74.59 / $105.32	Facility		$28.44	$74.59	$105.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $57.02 / $142.50	Professional		$34.40	$57.02	$142.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $32.90 / $69.00	Professional	26	$19.60	$32.90	$69.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $35.19 / $73.50	Professional	TC	$21.60	$35.19	$73.50
United Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $84.28 / $95.99	Professional		$31.28	$84.28	$95.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $40.39 / $46.00	Professional	26	$15.48	$40.39	$46.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $39.22 / $45.59	Professional	TC	$22.05	$39.22	$45.59