Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $33.15 / $55.51	Professional		$27.55	$33.15	$55.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $26.98 / $47.65	Professional	26	$22.71	$26.98	$47.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $4.83 / $6.17 / $7.86	Professional	TC	$4.83	$6.17	$7.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $26.29 / $102.00	Professional		$17.52	$26.29	$102.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $21.68 / $76.51	Professional	26	$16.41	$21.68	$76.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.11 / $4.16 / $53.00	Professional	TC	$1.11	$4.16	$53.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $72.78 / $93.99	Professional		$47.00	$72.78	$93.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.52 / $59.27 / $61.96	Professional	26	$38.52	$59.27	$61.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.28 / $12.63 / $15.37	Professional	TC	$6.28	$12.63	$15.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $49.00 / $101.25	Professional		$34.65	$49.00	$101.25
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $42.00 / $83.70	Professional	26	$29.50	$42.00	$83.70
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.38 / $8.40 / $21.16	Professional	TC	$2.38	$8.40	$21.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.29 / $45.80 / $108.00	Professional		$26.29	$45.80	$108.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $41.40 / $90.00	Professional	26	$24.00	$41.40	$90.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $2.20 / $7.20 / $19.50	Professional	TC	$2.20	$7.20	$19.50
United Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $64.45 / $68.48	Professional		$27.73	$64.45	$68.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $53.27 / $59.12	Professional	26	$19.03	$53.27	$59.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $9.36 / $30.44	Professional	TC	$5.50	$9.36	$30.44