Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.86 / $101.86 / $101.86	Facility	26	$101.86	$101.86	$101.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.09 / $82.77 / $171.60	Professional		$62.09	$82.77	$171.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.16 / $37.82 / $83.30	Professional	26	$30.16	$37.82	$83.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.55 / $208.62 / $265.32	Professional		$143.55	$208.62	$265.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $97.44 / $132.16	Professional	26	$57.02	$97.44	$132.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $197.33 / $236.79 / $330.65	Professional		$197.33	$236.79	$330.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.15 / $105.78 / $165.41	Professional	26	$88.15	$105.78	$165.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $305.00 / $446.52	Professional		$115.65	$305.00	$446.52
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.50 / $136.25 / $193.04	Professional	26	$49.50	$136.25	$193.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $209.33 / $385.50	Professional		$103.50	$209.33	$385.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $135.00 / $214.50	Professional	26	$55.00	$135.00	$214.50
United Facility/Professional Professional Modifier Low / Median / High Price $212.26 / $214.80 / $458.24	Professional		$212.26	$214.80	$458.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.66 / $105.74 / $211.48	Professional	26	$93.66	$105.74	$211.48