Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.41 / $103.71 / $167.18	Facility		$57.41	$103.71	$167.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.84 / $46.30 / $46.30	Professional		$10.84	$46.30	$46.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.17 / $38.17 / $38.17	Facility		$38.17	$38.17	$38.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $16.11 / $20.13	Professional		$8.71	$16.11	$20.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $10.87 / $10.87 / $10.87	Facility		$10.87	$10.87	$10.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13.82 / $13.82 / $55.28	Professional		$13.82	$13.82	$55.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.37 / $53.21 / $77.36	Facility		$48.37	$53.21	$77.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.44 / $31.10 / $31.10	Professional		$12.44	$31.10	$31.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $10.87 / $10.87 / $48.37	Facility		$10.87	$10.87	$48.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.44 / $13.82 / $15.50	Professional		$12.44	$13.82	$15.50
United Facility/Professional Professional Modifier Low / Median / High Price $7.54 / $27.64 / $41.70	Professional		$7.54	$27.64	$41.70