Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.54 / $50.54 / $50.54	Facility	26	$50.54	$50.54	$50.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $52.91 / $111.41	Professional		$40.95	$52.91	$111.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $23.78 / $49.09	Professional	26	$16.32	$23.78	$49.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.17 / $34.38 / $65.89	Professional	TC	$17.17	$34.38	$65.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $65.25 / $278.08	Professional		$29.18	$65.25	$278.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.25 / $26.35 / $135.55	Professional	26	$16.25	$26.35	$135.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.93 / $27.43 / $142.53	Professional	TC	$12.93	$27.43	$142.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.36 / $116.45 / $144.00	Professional		$63.36	$116.45	$144.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.95 / $49.54 / $57.19	Professional	26	$32.95	$49.54	$57.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.77 / $74.40 / $96.72	Professional	TC	$45.77	$74.40	$96.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $133.75 / $238.61	Professional		$61.00	$133.75	$238.61
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $62.40 / $95.16	Professional	26	$29.15	$62.40	$95.16
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.88 / $67.20 / $148.50	Professional	TC	$27.88	$67.20	$148.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $91.65 / $223.50	Professional		$50.50	$91.65	$223.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.00 / $60.09 / $104.00	Professional	26	$27.00	$60.09	$104.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.27 / $67.20 / $142.07	Professional	TC	$23.27	$67.20	$142.07
United Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $108.00 / $183.60	Professional		$61.02	$108.00	$183.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $52.64 / $89.49	Professional	26	$36.08	$52.64	$89.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $55.36 / $94.11	Professional	TC	$21.82	$55.36	$94.11