Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.47 / $34.47 / $34.47	Facility	26	$34.47	$34.47	$34.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.78 / $50.17 / $106.02	Professional		$40.78	$50.17	$106.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $13.25 / $29.12	Professional	26	$12.17	$13.25	$29.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.15 / $35.40 / $76.89	Professional	TC	$28.15	$35.40	$76.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $63.62 / $124.14	Professional		$37.21	$63.62	$124.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $19.11 / $41.60	Professional	26	$11.74	$19.11	$41.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.58 / $44.52 / $79.28	Professional	TC	$25.58	$44.52	$79.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $129.06 / $211.27	Professional		$71.09	$129.06	$211.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.52 / $34.92 / $67.79	Professional	26	$25.52	$34.92	$67.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.13 / $141.12 / $230.00	Professional		$66.13	$141.12	$230.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $43.20 / $66.50	Professional	26	$20.16	$43.20	$66.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.43 / $95.76 / $157.94	Professional	TC	$45.43	$95.76	$157.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.26 / $107.10 / $218.96	Professional		$52.26	$107.10	$218.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $39.60 / $70.20	Professional	26	$16.20	$39.60	$70.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $92.40 / $157.94	Professional	TC	$41.00	$92.40	$157.94
United Facility/Professional Professional Modifier Low / Median / High Price $65.80 / $100.68 / $214.37	Professional		$65.80	$100.68	$214.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.10 / $35.88 / $77.45	Professional	26	$19.10	$35.88	$77.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.95 / $64.86 / $150.62	Professional	TC	$32.95	$64.86	$150.62