Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $22.90 / $29.64	Professional	26	$10.48	$22.90	$29.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $33.03 / $34.56	Professional	TC	$16.26	$33.03	$34.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.79 / $32.61 / $186.91	Professional	26	$22.79	$32.61	$186.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.89 / $51.85 / $223.57	Professional	TC	$32.89	$51.85	$223.57
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $69.36 / $79.04	Professional	26	$46.13	$69.36	$79.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.28 / $86.53 / $112.48	Professional	TC	$53.28	$86.53	$112.48
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.88 / $98.55 / $133.59	Professional	26	$40.88	$98.55	$133.59
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.48 / $145.80 / $195.81	Professional	TC	$60.48	$145.80	$195.81
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.25 / $58.69 / $91.25	Professional	26	$24.25	$58.69	$91.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.11 / $67.67 / $135.00	Professional	TC	$34.11	$67.67	$135.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.49 / $61.49 / $64.98	Professional	26	$61.49	$61.49	$64.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.67 / $71.67 / $75.73	Professional	TC	$71.67	$71.67	$75.73