Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $163.61 / $204.42	Facility		$39.40	$163.61	$204.42
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $19.70 / $81.80 / $102.21	Facility	52	$19.70	$81.80	$102.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $20.10 / $182.70	Professional		$13.18	$20.10	$182.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.12 / $18.32 / $107.72	Professional		$13.12	$18.32	$107.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $18.59 / $30.17 / $49.69	Facility		$18.59	$30.17	$49.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $39.97 / $44.17	Professional		$19.95	$39.97	$44.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.83 / $49.20 / $74.76	Professional		$21.83	$49.20	$74.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.77 / $28.46 / $49.69	Facility		$15.77	$28.46	$49.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $37.79 / $77.70	Professional		$18.32	$37.79	$77.70
United Facility/Professional Professional Modifier Low / Median / High Price $21.22 / $41.84 / $75.67	Professional		$21.22	$41.84	$75.67