Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.02 / $205.51 / $213.73	Facility		$105.02	$205.51	$213.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.02 / $104.67 / $115.13	Professional		$84.02	$104.67	$115.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.07 / $115.07 / $115.07	Professional		$115.07	$115.07	$115.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $116.67 / $116.67 / $116.67	Facility		$116.67	$116.67	$116.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $102.74 / $102.74	Professional		$55.53	$102.74	$102.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.80 / $165.80 / $260.55	Facility		$165.80	$165.80	$260.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $81.59 / $81.59	Professional		$81.59	$81.59	$81.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $116.67 / $161.00 / $379.50	Facility		$116.67	$161.00	$379.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $79.23 / $115.07	Professional		$55.53	$79.23	$115.07
United Facility/Professional Professional Modifier Low / Median / High Price $102.74 / $102.74 / $123.14	Professional		$102.74	$102.74	$123.14