Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $102.33 / $489.78	Facility		$51.29	$102.33	$489.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $104.71 / $346.74 / $933.25	Facility	25	$104.71	$346.74	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $125.89	Professional		$26.92	$47.86	$125.89
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $31.62 / $66.07 / $208.93	Professional	25	$31.62	$66.07	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $52.48 / $165.96	Professional		$29.51	$52.48	$165.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $58.88 / $112.20	Facility		$30.20	$58.88	$112.20
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $104.71 / $251.19 / $933.25	Facility	25	$104.71	$251.19	$933.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $85.11 / $194.98	Professional		$36.31	$85.11	$194.98
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $34.67 / $70.79 / $165.96	Professional	25	$34.67	$70.79	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $3,467.37	Facility		$87.10	$87.10	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $141.25	Professional		$58.88	$91.20	$141.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $50.12 / $100.00	Facility		$28.18	$50.12	$100.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $75.86 / $144.54	Professional		$34.67	$75.86	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $81.28 / $144.54	Professional		$29.51	$81.28	$144.54