Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $262.93 / $262.93 / $262.93	Facility	26	$262.93	$262.93	$262.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $250.00 / $492.43	Professional	26	$90.00	$250.00	$492.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $282.18 / $282.18 / $307.70	Professional	26	$282.18	$282.18	$307.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.75 / $239.70 / $257.27	Professional	26	$199.75	$239.70	$257.27
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $308.75 / $334.80 / $452.01	Professional	26	$308.75	$334.80	$452.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $297.60 / $369.00 / $582.67	Professional	26	$297.60	$369.00	$582.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $134.33 / $246.16 / $369.24	Professional	26	$134.33	$246.16	$369.24