Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $208.93 / $309.03	Professional		$190.55	$208.93	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $316.23	Facility		$223.87	$223.87	$316.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $316.23	Professional		$173.78	$223.87	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $346.74 / $549.54	Facility		$316.23	$346.74	$549.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $457.09	Facility		$316.23	$316.23	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $251.19	Professional		$60.26	$60.26	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $269.15	Professional		$223.87	$223.87	$269.15