Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.79 / $173.79 / $173.79	Facility	26	$173.79	$173.79	$173.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.74 / $635.98 / $1,314.66	Professional		$300.74	$635.98	$1,314.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $833.26 / $833.26 / $1,359.75	Professional		$833.26	$833.26	$1,359.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $616.08 / $1,294.50 / $2,334.50	Professional		$616.08	$1,294.50	$2,334.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,621.25 / $1,786.05 / $3,955.85	Professional		$1,621.25	$1,786.05	$3,955.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $833.26 / $1,653.75 / $3,566.75	Professional		$833.26	$1,653.75	$3,566.75
United Facility/Professional Professional Modifier Low / Median / High Price $437.22 / $1,631.70 / $6,224.61	Professional		$437.22	$1,631.70	$6,224.61