Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $37.15	Professional	26	$10.00	$12.88	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $19.95 / $56.23	Professional	TC	$15.85	$19.95	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $32.36 / $91.20	Professional	26	$23.99	$32.36	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $51.29 / $109.65	Professional	TC	$33.88	$51.29	$109.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $66.07 / $91.20	Professional	26	$27.54	$66.07	$91.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $83.18 / $123.03	Professional	TC	$40.74	$83.18	$123.03
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $91.20	Professional	26	$23.99	$33.11	$91.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $50.12 / $109.65	Professional	TC	$33.11	$50.12	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $64.57	Professional	26	$61.66	$61.66	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $75.86	Professional	TC	$72.44	$72.44	$75.86