Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $269.15 / $338.84	Facility		$199.53	$269.15	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $245.47	Professional		$58.88	$91.20	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $169.82	Professional		$69.18	$107.15	$169.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $199.53 / $309.03	Facility		$77.62	$199.53	$309.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $263.03 / $436.52	Professional		$125.89	$263.03	$436.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $165.96 / $3,467.37	Facility		$125.89	$165.96	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $346.74	Professional		$128.82	$169.82	$346.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $97.72 / $199.53	Facility		$75.86	$97.72	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $245.47	Professional		$60.26	$104.71	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $229.09 / $257.04	Professional		$79.43	$229.09	$257.04