Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $194.98	Professional		$67.61	$79.43	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $158.49	Professional		$63.10	$77.62	$158.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $93.33 / $186.21	Facility		$61.66	$93.33	$186.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $199.53 / $316.23	Professional		$102.33	$199.53	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $295.12 / $3,467.37	Facility		$93.33	$295.12	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $316.23	Professional		$117.49	$213.80	$316.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $93.33 / $186.21	Facility		$61.66	$93.33	$186.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $177.83	Professional		$60.26	$91.20	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $194.98 / $354.81	Professional		$63.10	$194.98	$354.81