Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $100.00 / $213.80	Professional		$52.48	$100.00	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $281.84	Professional		$134.90	$162.18	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $363.08	Professional		$144.54	$204.17	$363.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $371.54 / $691.83	Professional		$275.42	$371.54	$691.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $134.90 / $281.84	Professional		$72.44	$134.90	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $338.84 / $501.19	Professional		$147.91	$338.84	$501.19