Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $43.68 / $55.04	Professional		$20.50	$43.68	$55.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.24 / $43.68 / $66.83	Facility		$30.24	$43.68	$66.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $128.52 / $208.50	Professional		$69.50	$128.52	$208.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.68 / $55.04 / $66.83	Facility		$43.68	$55.04	$66.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.27 / $139.00 / $317.62	Professional		$88.27	$139.00	$317.62
United Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $103.38 / $206.76	Professional		$83.34	$103.38	$206.76