Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.28 / $84.28 / $84.28	Professional		$84.28	$84.28	$84.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $84.28 / $117.99 / $120.52	Facility		$84.28	$117.99	$120.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.00 / $299.70 / $321.89	Professional		$264.00	$299.70	$321.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.28 / $117.99 / $120.52	Facility		$84.28	$117.99	$120.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $277.50 / $357.00	Professional		$225.00	$277.50	$357.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.02 / $132.30 / $239.28	Professional		$131.02	$132.30	$239.28