Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.24 / $86.79 / $147.46	Facility		$52.24	$86.79	$147.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $93.66	Professional		$42.13	$42.13	$93.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.08 / $142.08 / $142.08	Facility		$142.08	$142.08	$142.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.10 / $59.10 / $73.88	Professional		$59.10	$59.10	$73.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $165.60 / $205.72	Professional		$51.43	$165.60	$205.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.01 / $190.29 / $205.72	Facility		$180.01	$190.29	$205.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.29 / $77.15 / $115.72	Professional		$46.29	$77.15	$115.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $51.43 / $141.43	Professional		$48.86	$51.43	$141.43
United Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $94.42 / $94.42	Professional		$19.00	$94.42	$94.42