Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.98 / $110.87 / $509.36	Facility		$82.98	$110.87	$509.36
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $74.29 / $128.02 / $373.07	Facility	CQ	$74.29	$128.02	$373.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $27.97 / $81.65	Professional		$14.40	$27.97	$81.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $84.63 / $117.28	Professional		$32.76	$84.63	$117.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.78 / $57.56 / $94.94	Facility		$36.78	$57.56	$94.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $82.48 / $104.07	Professional		$45.79	$82.48	$104.07
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $30.50 / $30.50 / $30.50	Professional	CQ	$30.50	$30.50	$30.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $55.55 / $3,495.87	Facility		$55.55	$55.55	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $65.45 / $122.20	Professional		$47.00	$65.45	$122.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $3,495.87	Facility		$55.00	$55.00	$3,495.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $68.31 / $117.60	Professional		$35.65	$68.31	$117.60
United Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $93.82 / $131.35	Professional		$39.26	$93.82	$131.35