Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $31.16 / $51.57	Professional		$15.60	$31.16	$51.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.25 / $23.25 / $29.06	Professional		$20.25	$23.25	$29.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.79 / $38.09 / $53.33	Facility		$19.79	$38.09	$53.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $68.36 / $145.00	Professional		$45.70	$68.36	$145.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.60 / $38.09 / $53.33	Facility		$15.60	$38.09	$53.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $62.31 / $139.50	Professional		$32.40	$62.31	$139.50
United Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $82.06 / $164.12	Professional		$73.84	$82.06	$164.12