Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $18.52 / $22.90	Professional	26	$6.50	$18.52	$22.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $46.38 / $70.70	Professional	TC	$20.72	$46.38	$70.70
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 $70.67 / $111.44 / $480.38	Professional	TC	$70.67	$111.44	$480.38
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 $114.06 / $185.18 / $240.73	Professional	TC	$114.06	$185.18	$240.73
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 $129.91 / $313.20 / $419.07	Professional	TC	$129.91	$313.20	$419.07
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 $73.31 / $145.38 / $290.00	Professional	TC	$73.31	$145.38	$290.00
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 $154.00 / $154.00 / $162.74	Professional	TC	$154.00	$154.00	$162.74