Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.00 / $285.45 / $489.76	Facility		$146.00	$285.45	$489.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $139.93 / $160.15	Professional		$22.98	$139.93	$160.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.39 / $115.39 / $115.39	Facility		$115.39	$115.39	$115.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $47.91 / $59.89	Professional		$18.32	$47.91	$59.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.42 / $30.42 / $30.42	Facility		$30.42	$30.42	$30.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $41.77 / $167.08	Professional		$41.77	$41.77	$167.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $154.55 / $167.08	Facility		$136.00	$154.55	$167.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $93.98 / $93.98	Professional		$37.59	$93.98	$93.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.42 / $30.42 / $136.00	Facility		$30.42	$30.42	$136.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $36.06 / $41.77	Professional		$32.26	$36.06	$41.77
United Facility/Professional Professional Modifier Low / Median / High Price $15.70 / $83.54 / $126.03	Professional		$15.70	$83.54	$126.03