Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.03 / $275.39 / $302.93	Professional		$198.03	$275.39	$302.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $302.39	Professional		$302.39	$302.39	$302.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $328.19 / $328.19 / $328.19	Facility		$328.19	$328.19	$328.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $453.60 / $518.40 / $712.80	Facility		$453.60	$518.40	$712.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.50 / $229.50 / $229.50	Professional		$229.50	$229.50	$229.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $328.19 / $328.19 / $328.19	Facility		$328.19	$328.19	$328.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $302.39	Professional		$302.39	$302.39	$302.39
United Facility/Professional Professional Modifier Low / Median / High Price $247.34 / $247.34 / $324.00	Professional		$247.34	$247.34	$324.00