Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.76 / $58.76 / $58.76	Facility	26	$58.76	$58.76	$58.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $57.54 / $120.87	Professional		$32.64	$57.54	$120.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $21.89 / $52.92	Professional	26	$19.12	$21.89	$52.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.75 / $35.77 / $67.95	Professional	TC	$10.75	$35.77	$67.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $66.45 / $306.42	Professional		$32.60	$66.45	$306.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.35 / $27.26 / $157.66	Professional	26	$19.35	$27.26	$157.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.25 / $27.69 / $148.76	Professional	TC	$13.25	$27.69	$148.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $126.15 / $162.47	Professional		$56.53	$126.15	$162.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.38 / $57.71 / $65.76	Professional	26	$38.38	$57.71	$65.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.28 / $76.83 / $99.87	Professional	TC	$47.28	$76.83	$99.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $135.94 / $253.89	Professional		$67.59	$135.94	$253.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.95 / $73.20 / $110.36	Professional	26	$31.95	$73.20	$110.36
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $59.15 / $154.50	Professional	TC	$26.60	$59.15	$154.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $89.04 / $241.50	Professional		$48.18	$89.04	$241.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $73.20 / $124.00	Professional	26	$30.00	$73.20	$124.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $50.40 / $147.81	Professional	TC	$16.20	$50.40	$147.81
United Facility/Professional Professional Modifier Low / Median / High Price $47.23 / $119.00 / $202.30	Professional		$47.23	$119.00	$202.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.31 / $61.22 / $104.07	Professional	26	$31.31	$61.22	$104.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.77 / $57.78 / $98.23	Professional	TC	$22.77	$57.78	$98.23