Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.03 / $54.03 / $54.03	Facility	26	$54.03	$54.03	$54.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $90.76 / $187.31	Professional		$59.75	$90.76	$187.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.92 / $230.73 / $284.87	Professional		$169.92	$230.73	$284.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $214.25 / $263.94 / $348.78	Professional		$214.25	$263.94	$348.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.65 / $340.00 / $497.76	Professional		$133.65	$340.00	$497.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.62 / $239.50 / $445.50	Professional		$117.62	$239.50	$445.50
United Facility/Professional Professional Modifier Low / Median / High Price $223.24 / $227.90 / $455.80	Professional		$223.24	$227.90	$455.80