Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $363.08 / $630.96	Facility		$75.86	$363.08	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $169.82	Professional		$40.74	$48.98	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $229.09	Facility		$51.29	$51.29	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $165.96	Professional		$51.29	$51.29	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $190.55 / $204.17	Facility		$51.29	$190.55	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $141.25 / $245.47	Facility		$40.74	$141.25	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $102.33 / $154.88	Professional		$30.90	$102.33	$154.88