Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.10 / $101.10 / $101.10	Facility	26	$101.10	$101.10	$101.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $74.45 / $162.44	Professional		$64.76	$74.45	$162.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $41.88 / $91.03	Professional	26	$32.96	$41.88	$91.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.48 / $73.31 / $212.90	Professional		$46.48	$73.31	$212.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.42 / $43.19 / $271.10	Professional	26	$33.42	$43.19	$271.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.08 / $168.20 / $216.64	Professional		$84.08	$168.20	$216.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.39 / $99.82 / $113.75	Professional	26	$66.39	$99.82	$113.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.50 / $171.00 / $336.00	Professional		$93.50	$171.00	$336.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.50 / $127.20 / $192.15	Professional	26	$60.50	$127.20	$192.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $132.75 / $319.50	Professional		$77.84	$132.75	$319.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.30 / $127.20 / $208.65	Professional	26	$58.30	$127.20	$208.65
United Facility/Professional Professional Modifier Low / Median / High Price $73.41 / $170.32 / $308.04	Professional		$73.41	$170.32	$308.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.89 / $105.28 / $157.91	Professional	26	$40.89	$105.28	$157.91