Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.67 / $26.67 / $26.67	Facility	26	$26.67	$26.67	$26.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $63.70 / $150.18	Professional		$46.35	$63.70	$150.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $88.57 / $149.32	Professional		$44.92	$88.57	$149.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $139.74 / $223.51	Professional		$75.20	$139.74	$223.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.05 / $180.00 / $295.11	Professional		$83.05	$180.00	$295.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.49 / $139.44 / $299.70	Professional		$57.49	$139.44	$299.70
United Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $135.22 / $297.11	Professional		$53.40	$135.22	$297.11