Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.86 / $204.86 / $424.44	Facility		$204.86	$204.86	$424.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.13 / $122.67 / $122.67	Professional		$36.13	$122.67	$122.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $65.55 / $204.40	Professional		$47.00	$65.55	$204.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.33 / $122.67 / $122.67	Facility		$51.33	$122.67	$122.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.04 / $90.74 / $138.66	Professional		$62.04	$90.74	$138.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.45 / $109.45 / $3,495.87	Facility		$109.45	$109.45	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $119.40 / $221.00	Professional		$75.00	$119.40	$221.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.03 / $104.27 / $175.42	Facility		$42.03	$104.27	$175.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.65 / $111.44 / $220.00	Professional		$69.65	$111.44	$220.00
United Facility/Professional Professional Modifier Low / Median / High Price $149.54 / $163.52 / $245.28	Professional		$149.54	$163.52	$245.28