Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.32 / $100.16 / $314.17	Facility		$53.32	$100.16	$314.17
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $219.54 / $219.54 / $375.04	Facility	CO	$219.54	$219.54	$375.04
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $114.62 / $114.62 / $114.62	Facility	CQ	$114.62	$114.62	$114.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $27.16 / $70.33	Professional		$14.40	$27.16	$70.33
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $28.48 / $28.48 / $83.79	Professional	CQ	$28.48	$28.48	$83.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $84.63 / $116.06	Professional		$34.17	$84.63	$116.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.44 / $54.14 / $63.69	Facility		$31.44	$54.14	$63.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $87.20 / $104.07	Professional		$42.40	$87.20	$104.07
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $31.30 / $31.30 / $31.30	Professional	CQ	$31.30	$31.30	$31.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.90 / $53.90 / $3,495.87	Facility		$53.90	$53.90	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.50 / $63.70 / $121.25	Professional		$48.50	$63.70	$121.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.44 / $53.35 / $63.69	Facility		$31.44	$53.35	$63.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $68.59 / $116.40	Professional		$36.74	$68.59	$116.40
United Facility/Professional Professional Modifier Low / Median / High Price $76.64 / $90.02 / $126.03	Professional		$76.64	$90.02	$126.03