Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $77.62	Professional		$33.88	$41.69	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $33.11	Professional	26	$12.02	$15.14	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $43.65	Professional	TC	$21.88	$25.70	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $120.23	Professional		$37.15	$52.48	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.62 / $48.98	Professional	26	$13.80	$18.62	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $67.61	Professional	TC	$22.91	$33.88	$67.61
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $181.97	Professional		$60.26	$104.71	$181.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $41.69 / $72.44	Professional	26	$20.42	$41.69	$72.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $66.07 / $109.65	Professional	TC	$33.11	$66.07	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $213.80	Professional		$74.13	$141.25	$213.80
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $52.48 / $77.62	Professional	26	$27.54	$52.48	$77.62
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $89.13 / $134.90	Professional	TC	$45.71	$89.13	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $53.70 / $120.23	Professional		$37.15	$53.70	$120.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $52.48	Professional	26	$14.13	$18.62	$52.48
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $77.62	Professional	TC	$22.91	$33.11	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $97.72 / $229.09	Professional		$35.48	$97.72	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $41.69 / $91.20	Professional	26	$13.18	$41.69	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $54.95 / $128.82	Professional	TC	$21.38	$54.95	$128.82