Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $131.83	Facility		$123.03	$123.03	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $12.02 / $44.67	Professional		$10.00	$12.02	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $15.85 / $19.50	Professional		$10.00	$15.85	$19.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $45.71	Facility		$12.30	$12.30	$45.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.49 / $53.70	Professional		$13.49	$13.49	$53.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $52.48 / $87.10	Facility		$47.86	$52.48	$87.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $30.20	Professional		$25.12	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $12.30 / $12.30	Facility		$12.30	$12.30	$12.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $13.49 / $17.38	Professional		$10.00	$13.49	$17.38
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $26.92 / $40.74	Professional		$8.51	$26.92	$40.74