Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $35.65 / $39.74	Professional		$35.51	$35.65	$39.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.25 / $35.51 / $47.69	Facility		$21.25	$35.51	$47.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $53.50 / $137.69	Professional		$37.50	$53.50	$137.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.25 / $35.51 / $47.69	Facility		$21.25	$35.51	$47.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $52.50 / $112.50	Professional		$37.50	$52.50	$112.50
United Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $59.54 / $78.80	Professional		$23.86	$59.54	$78.80