Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.90 / $179.82 / $261.70	Facility		$53.90	$179.82	$261.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.25 / $73.67 / $92.08	Professional		$20.25	$73.67	$92.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.73 / $60.73 / $60.73	Facility		$60.73	$60.73	$60.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $25.19 / $31.49	Professional		$16.14	$25.19	$31.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.18 / $19.18 / $19.18	Facility		$19.18	$19.18	$19.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.99 / $21.99 / $87.96	Professional		$21.99	$21.99	$87.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.95 / $84.66 / $141.87	Facility		$76.95	$84.66	$141.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $49.48 / $194.63	Professional		$19.79	$49.48	$194.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.18 / $19.18 / $76.95	Facility		$19.18	$19.18	$76.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.99 / $22.00 / $31.77	Professional		$21.99	$22.00	$31.77
United Facility/Professional Professional Modifier Low / Median / High Price $13.83 / $43.98 / $54.30	Professional		$13.83	$43.98	$54.30