Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.69 / $61.60 / $82.66	Professional		$42.69	$61.60	$82.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.60 / $82.66 / $126.47	Facility		$61.60	$82.66	$126.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $267.50 / $391.62	Professional		$101.00	$267.50	$391.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.60 / $82.66 / $126.47	Facility		$61.60	$82.66	$126.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.27 / $254.52 / $461.57	Professional		$128.27	$254.52	$461.57
United Facility/Professional Professional Modifier Low / Median / High Price $173.55 / $178.06 / $267.08	Professional		$173.55	$178.06	$267.08