Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $275.42	Facility		$138.04	$138.04	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $117.49	Professional		$28.18	$33.88	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $56.23	Professional		$25.70	$25.70	$56.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $158.49	Facility		$35.48	$35.48	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $112.20	Professional		$35.48	$35.48	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $134.90 / $223.87	Facility		$123.03	$134.90	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $85.11 / $169.82	Facility		$28.18	$85.11	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $56.23	Professional		$25.70	$35.48	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $70.79 / $104.71	Professional		$20.89	$70.79	$104.71