Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $275.42 / $426.58	Facility		$151.36	$275.42	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $32.36 / $117.49	Professional		$28.18	$32.36	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $169.82	Facility		$35.48	$35.48	$169.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $112.20	Professional		$35.48	$35.48	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $128.82 / $141.25	Facility		$123.03	$128.82	$141.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $97.72 / $169.82	Facility		$28.18	$97.72	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $70.79 / $104.71	Professional		$20.89	$70.79	$104.71