Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.76 / $302.33 / $613.12	Facility		$55.76	$302.33	$613.12
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $473.30 / $473.30 / $473.30	Facility	CO	$473.30	$473.30	$473.30
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $78.30 / $170.73 / $738.00	Facility	CQ	$78.30	$170.73	$738.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $28.00 / $74.37	Professional		$12.00	$28.00	$74.37
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $29.20 / $29.20 / $132.15	Professional	CQ	$29.20	$29.20	$132.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $84.63 / $116.06	Professional		$30.69	$84.63	$116.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.04 / $58.10 / $113.16	Facility		$33.04	$58.10	$113.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $79.68 / $93.57	Professional		$41.17	$79.68	$93.57
Moda Health Facility/Professional Professional Modifier CO Low / Median / High Price $76.00 / $76.00 / $76.00	Professional	CO	$76.00	$76.00	$76.00
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $30.15 / $30.15 / $30.15	Professional	CQ	$30.15	$30.15	$30.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.40 / $48.40 / $3,495.87	Facility		$48.40	$48.40	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $60.03 / $111.25	Professional		$43.50	$60.03	$111.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.85 / $47.85 / $3,495.87	Facility		$47.85	$47.85	$3,495.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $62.87 / $114.34	Professional		$32.78	$62.87	$114.34
United Facility/Professional Professional Modifier Low / Median / High Price $75.61 / $81.96 / $114.74	Professional		$75.61	$81.96	$114.74