Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.62 / $72.62 / $97.03	Facility		$72.62	$72.62	$97.03
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $96.48 / $287.10 / $537.60	Facility	CQ	$96.48	$287.10	$537.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $23.85 / $58.10	Professional		$14.40	$23.85	$58.10
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $17.53 / $17.53 / $56.34	Professional	CQ	$17.53	$17.53	$56.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.97 / $84.66 / $116.06	Professional		$29.97	$84.66	$116.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.87 / $48.70 / $58.10	Facility		$25.87	$48.70	$58.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $79.68 / $93.57	Professional		$39.86	$79.68	$93.57
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 $40.00 / $59.34 / $107.50	Professional		$40.00	$59.34	$107.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.87 / $47.30 / $58.10	Facility		$25.87	$47.30	$58.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $62.15 / $113.94	Professional		$31.31	$62.15	$113.94
United Facility/Professional Professional Modifier Low / Median / High Price $32.89 / $81.14 / $113.60	Professional		$32.89	$81.14	$113.60