Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.45 / $330.19 / $539.39	Facility		$88.45	$330.19	$539.39
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $168.26 / $168.26 / $473.18	Facility	CO	$168.26	$168.26	$473.18
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $89.10 / $164.15 / $612.52	Facility	CQ	$89.10	$164.15	$612.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $28.61 / $76.42	Professional		$14.40	$28.61	$76.42
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $165.47 / $165.47 / $165.47	Professional	CQ	$165.47	$165.47	$165.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $84.63 / $117.60	Professional		$36.11	$84.63	$117.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.46 / $60.15 / $101.19	Facility		$39.46	$60.15	$101.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $92.92 / $112.48	Professional		$48.56	$92.92	$112.48
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $35.22 / $39.13 / $76.70	Professional	CQ	$35.22	$39.13	$76.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.50 / $60.50 / $3,495.87	Facility		$60.50	$60.50	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $73.45 / $135.60	Professional		$49.50	$73.45	$135.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.60 / $61.60 / $3,495.87	Facility		$61.60	$61.60	$3,495.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $78.20 / $117.79	Professional		$39.83	$78.20	$117.79
United Facility/Professional Professional Modifier Low / Median / High Price $95.36 / $101.86 / $142.60	Professional		$95.36	$101.86	$142.60