Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $55.16 / $90.24	Professional		$48.56	$55.16	$90.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $28.94 / $53.74	Professional	26	$25.82	$28.94	$53.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.73 / $26.22 / $36.50	Professional	TC	$22.73	$26.22	$36.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.75 / $132.00 / $319.11	Professional		$106.75	$132.00	$319.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $84.11 / $243.69	Professional	26	$68.73	$84.11	$243.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.17 / $45.60 / $133.44	Professional	TC	$36.17	$45.60	$133.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $191.70 / $304.20	Professional		$165.00	$191.70	$304.20
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.25 / $113.40 / $170.00	Professional	26	$106.25	$113.40	$170.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.75 / $78.30 / $134.68	Professional	TC	$58.75	$78.30	$134.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.91 / $154.84 / $288.60	Professional		$57.91	$154.84	$288.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.94 / $127.50 / $170.00	Professional	26	$67.94	$127.50	$170.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $55.30 / $105.00 / $142.00	Professional	TC	$55.30	$105.00	$142.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $146.32 / $220.85	Professional		$83.84	$146.32	$220.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $84.15 / $131.49	Professional	26	$42.79	$84.15	$131.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $58.77 / $104.74	Professional	TC	$40.78	$58.77	$104.74