Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $48.70 / $48.70	Professional		$48.70	$48.70	$48.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.70 / $68.18 / $69.64	Facility		$48.70	$68.18	$69.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $178.50 / $238.00	Professional		$157.50	$178.50	$238.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.70 / $68.18 / $69.64	Facility		$48.70	$68.18	$69.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $178.50 / $283.22	Professional		$157.50	$178.50	$283.22
United Facility/Professional Professional Modifier Low / Median / High Price $104.72 / $104.92 / $189.76	Professional		$104.72	$104.92	$189.76