Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $129.22 / $129.22	Professional		$129.22	$129.22	$129.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $184.78 / $184.78 / $184.78	Facility		$184.78	$184.78	$184.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.60 / $240.00 / $356.40	Professional		$115.60	$240.00	$356.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $184.78 / $184.78 / $184.78	Facility		$184.78	$184.78	$184.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.60 / $323.68 / $913.50	Professional		$115.60	$323.68	$913.50
United Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $537.55 / $821.47	Professional		$73.22	$537.55	$821.47