Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $87.10	Professional		$56.23	$66.07	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $61.66	Professional	26	$38.02	$44.67	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $208.93	Professional		$134.90	$158.49	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $158.49	Professional	26	$102.33	$117.49	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $173.78 / $295.12	Professional		$64.57	$173.78	$295.12
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $128.82 / $218.78	Professional	26	$45.71	$128.82	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $263.03 / $316.23	Professional		$120.23	$263.03	$316.23
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $177.83 / $223.87	Professional	26	$85.11	$177.83	$223.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $158.49 / $204.17	Professional		$74.13	$158.49	$204.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $79.43 / $158.49	Professional	26	$42.66	$79.43	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $363.08	Professional		$95.50	$169.82	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $125.89 / $275.42	Professional	26	$67.61	$125.89	$275.42