Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $69.54 / $94.64	Professional		$28.57	$69.54	$94.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $59.11 / $69.54 / $97.36	Facility		$59.11	$69.54	$97.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.75 / $195.75 / $3,495.87	Facility		$195.75	$195.75	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.24 / $249.40 / $500.50	Professional		$158.24	$249.40	$500.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.54 / $69.54 / $99.63	Facility		$69.54	$69.54	$99.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $171.60 / $314.60 / $543.40	Professional		$171.60	$314.60	$543.40
United Facility/Professional Professional Modifier Low / Median / High Price $124.59 / $250.62 / $532.57	Professional		$124.59	$250.62	$532.57