Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.42 / $101.99 / $166.57	Facility		$38.42	$101.99	$166.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $49.51 / $56.67	Professional		$13.59	$49.51	$56.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.84 / $40.84 / $40.84	Facility		$40.84	$40.84	$40.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.89 / $16.93 / $21.17	Professional		$10.89	$16.93	$21.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $13.42 / $13.42 / $13.42	Facility		$13.42	$13.42	$13.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.78 / $14.78 / $59.12	Professional		$14.78	$14.78	$59.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.73 / $56.90 / $95.37	Facility		$51.73	$56.90	$95.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.30 / $33.26 / $128.75	Professional		$13.30	$33.26	$128.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $13.42 / $13.42 / $51.73	Facility		$13.42	$13.42	$51.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.78 / $19.11 / $21.37	Professional		$14.78	$19.11	$21.37
United Facility/Professional Professional Modifier Low / Median / High Price $9.30 / $29.56 / $44.59	Professional		$9.30	$29.56	$44.59