Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $25.12 / $34.67	Professional		$22.91	$25.12	$34.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.89 / $28.84	Professional	26	$18.20	$20.89	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $6.03	Professional	TC	$3.02	$3.98	$6.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $28.84 / $102.33	Professional		$17.38	$28.84	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $25.12 / $75.86	Professional	26	$16.60	$25.12	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.12 / $4.17 / $52.48	Professional	TC	$1.12	$4.17	$52.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $95.50	Professional		$40.74	$58.88	$95.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $50.12 / $63.10	Professional	26	$28.84	$50.12	$63.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.17 / $9.77 / $15.49	Professional	TC	$6.17	$9.77	$15.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $66.07 / $102.33	Professional		$36.31	$66.07	$102.33
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $51.29 / $83.18	Professional	26	$30.20	$51.29	$83.18
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.03 / $14.13 / $17.38	Professional	TC	$6.03	$14.13	$17.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $31.62 / $85.11	Professional		$17.38	$31.62	$85.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.30 / $75.86	Professional	26	$16.60	$26.30	$75.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1.12 / $5.25 / $13.18	Professional	TC	$1.12	$5.25	$13.18
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $61.66 / $69.18	Professional		$24.55	$61.66	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $53.70 / $58.88	Professional	26	$19.95	$53.70	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.37 / $9.33 / $30.20	Professional	TC	$4.37	$9.33	$30.20