Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $134.90 / $208.93	Facility		$74.13	$134.90	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $57.54	Professional		$12.88	$15.85	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $83.18	Facility		$17.38	$17.38	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $17.38 / $54.95	Professional		$17.38	$17.38	$54.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $63.10 / $69.18	Facility		$60.26	$63.10	$69.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $47.86 / $83.18	Facility		$13.80	$47.86	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $34.67 / $52.48	Professional		$10.23	$34.67	$52.48