Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.60 / $197.60 / $197.60	Facility		$197.60	$197.60	$197.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.30 / $161.58 / $161.58	Professional		$56.30	$161.58	$161.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.73 / $74.48 / $250.76	Professional		$63.73	$74.48	$250.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.32 / $112.04 / $161.58	Facility		$53.32	$112.04	$161.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.76 / $200.75 / $241.94	Professional		$101.76	$200.75	$241.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $292.95 / $292.95 / $3,495.87	Facility		$292.95	$292.95	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $163.19 / $358.05	Professional		$101.50	$163.19	$358.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $112.04 / $231.06	Facility		$56.30	$112.04	$231.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $143.50 / $321.00	Professional		$92.25	$143.50	$321.00
United Facility/Professional Professional Modifier Low / Median / High Price $146.66 / $200.62 / $345.22	Professional		$146.66	$200.62	$345.22