Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.71 / $117.71 / $147.13	Professional		$117.71	$117.71	$147.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $359.05 / $359.05 / $359.05	Facility		$359.05	$359.05	$359.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.93 / $97.92 / $373.04	Professional		$83.93	$97.92	$373.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $345.06 / $359.05 / $373.04	Facility		$345.06	$359.05	$373.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.60 / $139.88 / $373.04	Professional		$88.60	$139.88	$373.04