Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $179.42 / $179.42	Professional		$88.00	$179.42	$179.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.35 / $131.35 / $131.35	Professional		$131.35	$131.35	$131.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $256.57 / $256.57 / $256.57	Facility		$256.57	$256.57	$256.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $28.60 / $40.85	Professional		$28.60	$28.60	$40.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.20 / $179.20 / $281.60	Facility		$179.20	$179.20	$281.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $179.20 / $256.00 / $422.40	Facility		$179.20	$256.00	$422.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $40.85 / $131.35	Professional		$28.60	$40.85	$131.35
United Facility/Professional Professional Modifier Low / Median / High Price $117.28 / $117.28 / $140.74	Professional		$117.28	$117.28	$140.74