Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.24 / $99.02 / $168.25	Facility		$21.24	$99.02	$168.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.22 / $48.07 / $55.02	Professional		$13.22	$48.07	$55.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.65 / $39.65 / $39.65	Facility		$39.65	$39.65	$39.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.53 / $16.52 / $20.65	Professional		$10.53	$16.52	$20.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $13.01 / $13.01 / $13.01	Facility		$13.01	$13.01	$13.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.35 / $14.35 / $57.40	Professional		$14.35	$14.35	$57.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.23 / $55.25 / $92.52	Facility		$50.23	$55.25	$92.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.92 / $32.29 / $32.29	Professional		$12.92	$32.29	$32.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $13.01 / $13.01 / $50.23	Facility		$13.01	$13.01	$50.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.35 / $18.54 / $20.73	Professional		$14.35	$18.54	$20.73
United Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $28.70 / $43.30	Professional		$9.02	$28.70	$43.30