Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.93 / $97.58 / $165.80	Facility		$20.93	$97.58	$165.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $47.37 / $54.21	Professional		$13.00	$47.37	$54.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.06 / $39.06 / $39.06	Facility		$39.06	$39.06	$39.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.35 / $16.52 / $20.65	Professional		$10.35	$16.52	$20.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.83 / $12.83 / $12.83	Facility		$12.83	$12.83	$12.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $14.14 / $56.56	Professional		$14.14	$14.14	$56.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.49 / $54.44 / $91.25	Facility		$49.49	$54.44	$91.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.73 / $31.82 / $156.25	Professional		$12.73	$31.82	$156.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.83 / $12.83 / $49.49	Facility		$12.83	$12.83	$49.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $14.14 / $20.44	Professional		$14.14	$14.14	$20.44
United Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $28.28 / $42.66	Professional		$8.90	$28.28	$42.66