Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $116.29 / $197.58	Facility		$24.94	$116.29	$197.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $56.45 / $64.59	Professional		$15.50	$56.45	$64.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.54 / $46.54 / $46.54	Facility		$46.54	$46.54	$46.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $19.41 / $24.26	Professional		$12.34	$19.41	$24.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Facility		$16.98	$16.98	$16.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.85 / $16.85 / $67.40	Professional		$16.85	$16.85	$67.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.98 / $64.87 / $108.69	Facility		$58.98	$64.87	$108.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.17 / $37.90 / $37.90	Professional		$15.17	$37.90	$37.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $58.98	Facility		$16.98	$16.98	$58.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.85 / $21.78 / $24.34	Professional		$16.85	$21.78	$24.34
United Facility/Professional Professional Modifier Low / Median / High Price $10.59 / $33.70 / $50.84	Professional		$10.59	$33.70	$50.84