Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.13 / $107.13 / $107.13	Professional		$107.13	$107.13	$107.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.67 / $93.67 / $153.19	Facility		$93.67	$93.67	$153.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.50 / $379.35 / $524.00	Professional		$327.50	$379.35	$524.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.13 / $146.77 / $153.19	Facility		$107.13	$146.77	$153.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $314.39 / $393.00 / $524.00	Professional		$314.39	$393.00	$524.00
United Facility/Professional Professional Modifier Low / Median / High Price $214.26 / $214.60 / $461.39	Professional		$214.26	$214.60	$461.39