Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $141.25 / $208.93	Facility		$87.10	$141.25	$208.93
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $177.83 / $177.83 / $251.19	Facility	25	$177.83	$177.83	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $181.97	Professional		$38.90	$69.18	$181.97
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $39.81 / $104.71 / $371.54	Professional	25	$39.81	$104.71	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $89.13 / $223.87	Professional		$54.95	$89.13	$223.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $91.20 / $162.18	Facility		$47.86	$91.20	$162.18
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $177.83 / $177.83 / $251.19	Facility	25	$177.83	$177.83	$251.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $120.23 / $257.04	Professional		$53.70	$120.23	$257.04
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $47.86 / $114.82 / $251.19	Professional	25	$47.86	$114.82	$251.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $3,467.37	Facility		$114.82	$114.82	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $223.87	Professional		$100.00	$151.36	$223.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $77.62 / $147.91	Facility		$42.66	$77.62	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $190.55	Professional		$58.88	$97.72	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $154.88 / $239.88	Professional		$53.70	$154.88	$239.88