Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $134.90	Facility		$109.65	$109.65	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $107.15	Professional		$40.74	$52.48	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $190.55	Professional		$40.74	$63.10	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $64.57 / $112.20	Facility		$42.66	$64.57	$112.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $102.33 / $173.78	Professional		$58.88	$102.33	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $251.19	Professional		$85.11	$158.49	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $70.79 / $128.82	Facility		$41.69	$70.79	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $165.96	Professional		$45.71	$67.61	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $131.83 / $234.42	Professional		$51.29	$131.83	$234.42