Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.27 / $188.36 / $294.32	Facility		$104.27	$188.36	$294.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.54 / $188.36 / $290.11	Professional		$171.54	$188.36	$290.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.36 / $69.36 / $69.36	Facility		$69.36	$69.36	$69.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $84.09 / $117.73 / $120.25	Facility		$84.09	$117.73	$120.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $25.10 / $100.40	Professional		$25.10	$25.10	$100.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.85 / $92.87 / $100.40	Facility		$87.85	$92.87	$100.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.48 / $56.48 / $111.40	Professional		$56.48	$56.48	$111.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.36 / $92.87 / $117.73	Facility		$69.36	$92.87	$117.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $37.65 / $111.40	Professional		$25.07	$37.65	$111.40
United Facility/Professional Professional Modifier Low / Median / High Price $10.54 / $50.20 / $75.73	Professional		$10.54	$50.20	$75.73