Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.80 / $247.54 / $330.73	Facility		$200.80	$247.54	$330.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.90 / $110.24 / $247.54	Professional		$62.90	$110.24	$247.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $83.82 / $100.71	Professional		$63.53	$83.82	$100.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $126.19 / $198.04 / $340.56	Facility		$126.19	$198.04	$340.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $148.00 / $252.38 / $318.52	Professional		$148.00	$252.38	$318.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.55 / $165.55 / $3,495.87	Facility		$165.55	$165.55	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.41 / $168.56 / $330.00	Professional		$121.41	$168.56	$330.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.43 / $168.33 / $198.04	Facility		$112.43	$168.33	$198.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.50 / $133.19 / $237.75	Professional		$75.50	$133.19	$237.75
United Facility/Professional Professional Modifier Low / Median / High Price $184.30 / $227.52 / $257.75	Professional		$184.30	$227.52	$257.75