Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $23.27 / $25.76	Facility	26	$18.62	$23.27	$25.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $43.11 / $93.27	Professional		$27.61	$43.11	$93.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $12.12 / $28.27	Professional	26	$8.09	$12.12	$28.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $33.35 / $68.73	Professional	TC	$19.14	$33.35	$68.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $55.56 / $93.60	Professional		$25.71	$55.56	$93.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $12.70 / $27.49	Professional	26	$7.82	$12.70	$27.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $42.86 / $69.08	Professional	TC	$17.89	$42.86	$69.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.73 / $70.52 / $110.38	Professional		$46.73	$70.52	$110.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.07 / $23.28 / $44.80	Professional	26	$15.07	$23.28	$44.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $46.90 / $85.51	Professional	TC	$29.70	$46.90	$85.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.90 / $110.70 / $192.50	Professional		$55.90	$110.70	$192.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $28.80 / $43.92	Professional	26	$13.62	$28.80	$43.92
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.80 / $78.30 / $148.19	Professional	TC	$41.80	$78.30	$148.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.25 / $84.77 / $188.70	Professional		$33.25	$84.77	$188.70
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $26.40 / $46.80	Professional	26	$10.80	$26.40	$46.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $76.83 / $151.75	Professional	TC	$34.65	$76.83	$151.75
United Facility/Professional Professional Modifier Low / Median / High Price $32.51 / $84.72 / $201.21	Professional		$32.51	$84.72	$201.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $23.72 / $56.34	Professional	26	$8.15	$23.72	$56.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $61.00 / $131.69	Professional	TC	$24.42	$61.00	$131.69