Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.47 / $216.47 / $216.47	Facility	26	$216.47	$216.47	$216.47
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 $223.90 / $223.90 / $254.40	Professional	26	$223.90	$223.90	$254.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $164.98 / $197.97 / $212.49	Professional	26	$164.98	$197.97	$212.49
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $255.00 / $274.05 / $373.32	Professional	26	$255.00	$274.05	$373.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $244.80 / $304.50 / $466.14	Professional	26	$244.80	$304.50	$466.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.68 / $203.36 / $305.27	Professional	26	$100.68	$203.36	$305.27