Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $29.51 / $32.36	Facility	26	$23.44	$29.51	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $58.88 / $95.50	Professional		$37.15	$58.88	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $26.30	Professional	26	$10.00	$12.88	$26.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $45.71 / $66.07	Professional	TC	$26.92	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $162.18	Professional		$41.69	$67.61	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.49 / $38.90	Professional	26	$10.00	$15.49	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $51.29 / $123.03	Professional	TC	$31.62	$51.29	$123.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $29.51 / $32.36	Facility	26	$23.44	$29.51	$32.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $194.98	Professional		$61.66	$107.15	$194.98
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $30.20 / $52.48	Professional	26	$14.79	$30.20	$52.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $77.62 / $131.83	Professional	TC	$46.77	$77.62	$131.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $302.00	Professional		$109.65	$158.49	$302.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $64.57	Professional	26	$23.99	$40.74	$64.57
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $117.49 / $234.42	Professional	TC	$85.11	$117.49	$234.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $125.89	Professional		$42.66	$72.44	$125.89
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $45.71	Professional	26	$10.00	$14.79	$45.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $45.71 / $128.82	Professional	TC	$31.62	$45.71	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $141.25 / $323.59	Professional		$47.86	$141.25	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $37.15 / $87.10	Professional	26	$10.72	$37.15	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $104.71 / $223.87	Professional	TC	$37.15	$104.71	$223.87