Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.23 / $71.23 / $71.23	Facility	26	$71.23	$71.23	$71.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $64.48 / $137.61	Professional		$47.53	$64.48	$137.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $28.87 / $64.14	Professional	26	$23.21	$28.87	$64.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.67 / $38.19 / $73.48	Professional	TC	$18.67	$38.19	$73.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $80.00 / $350.22	Professional		$37.94	$80.00	$350.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $33.07 / $191.07	Professional	26	$23.42	$33.07	$191.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $29.83 / $159.15	Professional	TC	$14.51	$29.83	$159.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $146.46 / $185.02	Professional		$65.08	$146.46	$185.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.63 / $70.11 / $79.89	Professional	26	$46.63	$70.11	$79.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.78 / $82.48 / $107.22	Professional	TC	$50.78	$82.48	$107.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $171.25 / $305.51	Professional		$78.65	$171.25	$305.51
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $90.00 / $133.50	Professional	26	$38.86	$90.00	$133.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.28 / $71.79 / $165.00	Professional	TC	$31.28	$71.79	$165.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $114.95 / $276.49	Professional		$59.50	$114.95	$276.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $88.80 / $150.00	Professional	26	$37.00	$88.80	$150.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $63.70 / $157.85	Professional	TC	$24.97	$63.70	$157.85
United Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $136.00 / $231.20	Professional		$47.20	$136.00	$231.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.51 / $74.20 / $148.40	Professional	26	$43.51	$74.20	$148.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.70 / $61.80 / $93.23	Professional	TC	$36.70	$61.80	$93.23