Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.91 / $19.91 / $19.91	Facility	26	$19.91	$19.91	$19.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $39.40 / $61.27	Professional		$31.75	$39.40	$61.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $9.72 / $27.81	Professional	26	$8.07	$9.72	$27.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $29.68 / $41.36	Professional	TC	$23.57	$29.68	$41.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $42.24 / $80.41	Professional		$25.17	$42.24	$80.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $10.79 / $25.94	Professional	26	$7.17	$10.79	$25.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.01 / $27.86 / $54.47	Professional	TC	$18.01	$27.86	$54.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.85 / $71.81 / $104.06	Professional		$42.85	$71.81	$104.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.37 / $47.12	Professional	26	$16.98	$20.37	$47.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.85 / $51.42 / $96.51	Professional	TC	$42.85	$51.42	$96.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.24 / $101.25 / $136.50	Professional		$84.24	$101.25	$136.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.68 / $28.35 / $38.43	Professional	26	$22.68	$28.35	$38.43
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.56 / $72.90 / $99.75	Professional	TC	$61.56	$72.90	$99.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $73.50 / $136.50	Professional		$34.70	$73.50	$136.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $31.50 / $40.40	Professional	26	$13.38	$31.50	$40.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $81.00 / $105.45	Professional	TC	$28.85	$81.00	$105.45
United Facility/Professional Professional Modifier Low / Median / High Price $54.89 / $64.31 / $104.52	Professional		$54.89	$64.31	$104.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $20.76 / $33.74	Professional	26	$11.30	$20.76	$33.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.79 / $43.56 / $70.78	Professional	TC	$40.79	$43.56	$70.78