Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $154.88	Professional		$33.11	$50.12	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.92 / $61.66	Professional	26	$18.20	$26.92	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.91 / $83.18	Professional	TC	$14.13	$22.91	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $81.28 / $141.25	Professional		$36.31	$81.28	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $50.12 / $77.62	Professional	26	$21.38	$50.12	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $30.90 / $66.07	Professional	TC	$14.45	$30.90	$66.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $190.55	Professional		$97.72	$117.49	$190.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $63.10 / $100.00	Professional	26	$41.69	$63.10	$100.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $104.71	Professional	TC	$41.69	$48.98	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $213.80	Professional		$128.82	$158.49	$213.80
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $85.11 / $120.23	Professional	26	$75.86	$85.11	$120.23
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $97.72	Professional	TC	$53.70	$72.44	$97.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $77.62 / $102.33	Professional		$36.31	$77.62	$102.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $30.20 / $77.62	Professional	26	$16.60	$30.20	$77.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $22.39 / $47.86	Professional	TC	$14.45	$22.39	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $100.00 / $147.91	Professional		$97.72	$100.00	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $64.57	Professional	26	$53.70	$61.66	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $38.02 / $56.23	Professional	TC	$36.31	$38.02	$56.23