Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $114.85 / $114.85	Professional		$93.53	$114.85	$114.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.15 / $114.85 / $164.24	Facility		$89.15	$114.85	$164.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.60 / $380.70 / $512.00	Professional		$281.60	$380.70	$512.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.15 / $114.85 / $164.24	Facility		$89.15	$114.85	$164.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $252.16 / $384.00 / $492.54	Professional		$252.16	$384.00	$492.54
United Facility/Professional Professional Modifier Low / Median / High Price $109.51 / $150.44 / $272.08	Professional		$109.51	$150.44	$272.08