Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $85.11	Professional		$37.15	$45.71	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $26.92	Professional	26	$10.00	$12.88	$26.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $58.88	Professional	TC	$25.70	$33.11	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $60.26 / $131.83	Professional		$41.69	$60.26	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.49 / $40.74	Professional	26	$11.48	$15.49	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $44.67 / $89.13	Professional	TC	$30.90	$44.67	$89.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $208.93	Professional		$70.79	$123.03	$208.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $34.67 / $61.66	Professional	26	$17.38	$34.67	$61.66
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $89.13 / $151.36	Professional	TC	$51.29	$89.13	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $154.88 / $245.47	Professional		$81.28	$154.88	$245.47
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $64.57	Professional	26	$22.91	$43.65	$64.57
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $112.20 / $173.78	Professional	TC	$58.88	$112.20	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $60.26 / $131.83	Professional		$41.69	$60.26	$131.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.49 / $43.65	Professional	26	$11.75	$15.49	$43.65
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $41.69 / $102.33	Professional	TC	$29.51	$41.69	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $104.71 / $229.09	Professional		$38.90	$104.71	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $34.67 / $75.86	Professional	26	$10.96	$34.67	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $70.79 / $151.36	Professional	TC	$27.54	$70.79	$151.36