Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.00 / $113.00 / $113.00	Facility	26	$113.00	$113.00	$113.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.86 / $513.24 / $513.24	Professional		$215.86	$513.24	$513.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.90 / $497.90 / $559.02	Professional		$497.90	$497.90	$559.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $414.03 / $533.26	Professional		$251.28	$414.03	$533.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $640.00 / $703.35 / $936.96	Professional		$640.00	$703.35	$936.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $661.25 / $1,220.19	Professional		$251.28	$661.25	$1,220.19
United Facility/Professional Professional Modifier Low / Median / High Price $252.03 / $447.22 / $670.83	Professional		$252.03	$447.22	$670.83