Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $323.59 / $478.63	Facility		$234.42	$323.59	$478.63
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $316.23 / $323.59 / $354.81	Facility	25	$316.23	$323.59	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $436.52	Professional		$104.71	$165.96	$436.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $131.83 / $229.09 / $616.60	Professional	25	$131.83	$229.09	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $194.98 / $537.03	Professional		$131.83	$194.98	$537.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $218.78 / $389.05	Facility		$114.82	$218.78	$389.05
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $316.23 / $323.59 / $354.81	Facility	25	$316.23	$323.59	$354.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $295.12 / $602.56	Professional		$128.82	$295.12	$602.56
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $223.87 / $524.81	Professional	25	$128.82	$223.87	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $3,467.37	Facility		$323.59	$323.59	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $363.08 / $512.86	Professional		$263.03	$363.08	$512.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $186.21 / $346.74	Facility		$112.20	$186.21	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $234.42 / $436.52	Professional		$120.23	$234.42	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $398.11 / $537.03	Professional		$128.82	$398.11	$537.03