Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.43 / $87.10 / $147.97	Facility		$52.43	$87.10	$147.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Professional		$42.28	$42.28	$42.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.79 / $116.79 / $116.79	Facility		$116.79	$116.79	$116.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.57 / $48.57 / $60.71	Professional		$48.57	$48.57	$60.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $136.13 / $169.12	Professional		$42.28	$136.13	$169.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.97 / $156.44 / $169.12	Facility		$147.97	$156.44	$169.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $63.42 / $95.13	Professional		$38.04	$63.42	$95.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.28 / $42.28 / $42.28	Facility		$42.28	$42.28	$42.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $42.28 / $116.27	Professional		$40.17	$42.28	$116.27
United Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $94.10 / $142.44	Professional		$19.00	$94.10	$142.44