Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $207.25 / $207.25 / $207.25	Facility	26	$207.25	$207.25	$207.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $126.13 / $303.30	Professional		$104.87	$126.13	$303.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.95 / $68.92 / $228.24	Professional	26	$58.95	$68.92	$228.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.43 / $267.43 / $310.01	Professional		$267.43	$267.43	$310.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $206.62 / $206.62 / $238.80	Professional	26	$206.62	$206.62	$238.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $231.28 / $320.32 / $764.40	Professional		$231.28	$320.32	$764.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.51 / $210.39 / $574.47	Professional	26	$81.51	$210.39	$574.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.50 / $414.70 / $590.04	Professional		$357.50	$414.70	$590.04
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $252.50 / $292.89 / $431.36	Professional	26	$252.50	$292.89	$431.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $124.45 / $396.00 / $599.25	Professional		$124.45	$396.00	$599.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $240.00 / $322.74 / $456.96	Professional	26	$240.00	$322.74	$456.96
United Facility/Professional Professional Modifier Low / Median / High Price $245.08 / $248.00 / $625.91	Professional		$245.08	$248.00	$625.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $170.13 / $191.04 / $482.16	Professional	26	$170.13	$191.04	$482.16