Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.39 / $91.39 / $91.39	Facility	26	$91.39	$91.39	$91.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $250.00 / $291.50	Professional	26	$90.00	$250.00	$291.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.78 / $95.78 / $109.65	Professional	26	$95.78	$95.78	$109.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.55 / $83.46 / $89.58	Professional	26	$69.55	$83.46	$89.58
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.50 / $114.75 / $157.38	Professional	26	$107.50	$114.75	$157.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $132.00 / $201.08	Professional	26	$103.20	$132.00	$201.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.70 / $87.56 / $131.58	Professional	26	$46.70	$87.56	$131.58