Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.33 / $155.41 / $264.04	Facility		$33.33	$155.41	$264.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.67 / $75.44 / $86.34	Professional		$20.67	$75.44	$86.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $62.22 / $62.22	Facility		$62.22	$62.22	$62.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.52 / $26.02 / $32.52	Professional		$16.52	$26.02	$32.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $20.41 / $20.41 / $20.41	Facility		$20.41	$20.41	$20.41
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $22.52 / $90.08	Professional		$22.52	$22.52	$90.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.81 / $86.70 / $145.22	Facility		$78.81	$86.70	$145.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.27 / $50.67 / $50.67	Professional		$20.27	$50.67	$50.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.41 / $20.41 / $78.81	Facility		$20.41	$20.41	$78.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $22.52 / $32.53	Professional		$22.52	$22.52	$32.53
United Facility/Professional Professional Modifier Low / Median / High Price $14.15 / $45.04 / $67.95	Professional		$14.15	$45.04	$67.95