Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $70.79 / $131.83	Facility		$51.29	$70.79	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $97.72	Professional		$51.29	$51.29	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $63.10	Professional		$28.18	$28.18	$63.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $56.23 / $158.49	Facility		$51.29	$56.23	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $54.95 / $165.96	Professional		$51.29	$54.95	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $190.55 / $204.17	Facility		$51.29	$190.55	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $141.25	Facility		$51.29	$51.29	$141.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $51.29 / $63.10	Professional		$28.18	$51.29	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $154.88	Professional		$51.29	$51.29	$154.88