Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.85 / $187.60 / $293.13	Facility		$103.85	$187.60	$293.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.85 / $187.60 / $288.94	Professional		$170.85	$187.60	$288.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.06 / $69.06 / $69.06	Facility		$69.06	$69.06	$69.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $119.76 / $119.76 / $119.76	Facility		$119.76	$119.76	$119.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $25.00 / $80.50	Professional		$22.50	$25.00	$80.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.50 / $92.50 / $100.00	Facility		$87.50	$92.50	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $56.25 / $56.25	Professional		$22.50	$56.25	$56.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.06 / $92.50 / $119.76	Facility		$69.06	$92.50	$119.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $68.75 / $68.75	Professional		$22.50	$68.75	$68.75
United Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $50.00 / $75.43	Professional		$25.00	$50.00	$75.43