Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.17 / $7.17 / $7.17	Facility	26	$7.17	$7.17	$7.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $26.17 / $68.98	Professional		$15.66	$26.17	$68.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $5.53 / $12.26	Professional	26	$3.01	$5.53	$12.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.58 / $21.19 / $56.74	Professional	TC	$12.58	$21.19	$56.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.01 / $42.47 / $64.45	Professional		$14.01	$42.47	$64.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.59 / $7.97 / $14.42	Professional	26	$2.59	$7.97	$14.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.42 / $33.28 / $48.85	Professional	TC	$11.42	$33.28	$48.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $43.47 / $68.43	Professional		$23.02	$43.47	$68.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.98 / $7.77 / $14.11	Professional	26	$4.98	$7.77	$14.11
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.17 / $29.93 / $54.32	Professional	TC	$19.17	$29.93	$54.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $65.25 / $136.50	Professional		$36.00	$65.25	$136.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $13.02 / $28.00	Professional	26	$7.92	$13.02	$28.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $53.65 / $108.50	Professional	TC	$28.00	$53.65	$108.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $55.44 / $136.50	Professional		$18.44	$55.44	$136.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $13.50 / $30.40	Professional	26	$6.46	$13.50	$30.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.85 / $54.00 / $117.80	Professional	TC	$23.85	$54.00	$117.80
United Facility/Professional Professional Modifier Low / Median / High Price $20.36 / $51.56 / $136.50	Professional		$20.36	$51.56	$136.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.30 / $11.54 / $27.41	Professional	26	$4.30	$11.54	$27.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $40.02 / $103.74	Professional	TC	$16.05	$40.02	$103.74