Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $141.25 / $239.88	Facility		$28.84	$141.25	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $64.57	Professional		$15.14	$19.05	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $22.91 / $28.18	Professional		$14.45	$22.91	$28.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $21.38 / $21.38	Facility		$19.50	$21.38	$21.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $77.62	Professional		$19.50	$19.50	$77.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $75.86 / $125.89	Facility		$69.18	$75.86	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $43.65 / $43.65	Professional		$36.31	$43.65	$43.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Facility		$21.38	$21.38	$21.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $19.50 / $25.12	Professional		$14.45	$19.50	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $38.90 / $58.88	Professional		$12.30	$38.90	$58.88