Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $37.92 / $53.92	Professional		$27.89	$37.92	$53.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.33 / $53.92 / $82.50	Facility		$30.33	$53.92	$82.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $159.30 / $215.94	Professional		$69.50	$159.30	$215.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.33 / $53.92 / $82.50	Facility		$30.33	$53.92	$82.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.27 / $163.75 / $317.62	Professional		$88.27	$163.75	$317.62
United Facility/Professional Professional Modifier Low / Median / High Price $103.38 / $109.81 / $223.18	Professional		$103.38	$109.81	$223.18