Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $141.25 / $239.88	Facility		$29.51	$141.25	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.05 / $66.07	Professional		$15.85	$19.05	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $22.91 / $28.18	Professional		$11.75	$22.91	$28.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $14.45 / $19.95	Facility		$14.45	$14.45	$19.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $79.43	Professional		$19.95	$19.95	$79.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $75.86 / $102.33	Facility		$69.18	$75.86	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $44.67	Professional		$29.51	$44.67	$44.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $14.45 / $14.45	Facility		$14.45	$14.45	$14.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $17.78 / $20.42	Professional		$11.75	$17.78	$20.42
United Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $39.81 / $60.26	Professional		$10.00	$39.81	$60.26