Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.33 / $196.00 / $803.90	Facility		$51.33	$196.00	$803.90
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $210.02 / $359.40 / $658.73	Facility	25	$210.02	$359.40	$658.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.80 / $89.00 / $194.35	Professional		$47.80	$89.00	$194.35
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.86 / $98.35 / $281.06	Professional	25	$60.86	$98.35	$281.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.05 / $118.05 / $118.05	Facility		$118.05	$118.05	$118.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.87 / $99.48 / $306.99	Professional		$56.87	$99.48	$306.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $65.70 / $134.63 / $235.14	Facility		$65.70	$134.63	$235.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $159.30 / $223.25 / $389.79	Professional		$159.30	$223.25	$389.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.72 / $160.72 / $3,495.87	Facility		$160.72	$160.72	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $188.10 / $279.89	Professional		$120.35	$188.10	$279.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.29 / $128.51 / $235.14	Facility		$59.29	$128.51	$235.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.75 / $164.73 / $253.75	Professional		$79.75	$164.73	$253.75
United Facility/Professional Professional Modifier Low / Median / High Price $177.30 / $206.00 / $252.79	Professional		$177.30	$206.00	$252.79