Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.27 / $118.27 / $118.27	Facility		$118.27	$118.27	$118.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.65 / $112.65 / $112.65	Facility	26	$112.65	$112.65	$112.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.98 / $90.98 / $90.98	Professional		$90.98	$90.98	$90.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $86.65 / $126.41	Professional	26	$17.23	$86.65	$126.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.93 / $8.93 / $8.93	Facility		$8.93	$8.93	$8.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $130.10 / $130.10 / $130.10	Facility		$130.10	$130.10	$130.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $141.69 / $255.50	Professional		$24.70	$141.69	$255.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.98 / $131.97 / $141.65	Professional	26	$109.98	$131.97	$141.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.50 / $198.45 / $267.18	Professional		$182.50	$198.45	$267.18
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.00 / $184.95 / $248.88	Professional	26	$65.00	$184.95	$248.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.93 / $8.93 / $130.10	Facility		$8.93	$8.93	$130.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.29 / $183.75 / $242.55	Professional		$17.29	$183.75	$242.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $65.00 / $118.82 / $227.70	Professional	26	$65.00	$118.82	$227.70
United Facility/Professional Professional Modifier Low / Median / High Price $29.20 / $52.34 / $78.95	Professional		$29.20	$52.34	$78.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $51.72 / $78.93	Professional	26	$29.19	$51.72	$78.93