Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.35 / $298.89 / $961.00	Facility		$161.35	$298.89	$961.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $77.86 / $398.12 / $966.94	Facility	25	$77.86	$398.12	$966.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $136.49 / $298.83	Professional		$67.65	$136.49	$298.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $65.75 / $172.91 / $414.49	Professional	25	$65.75	$172.91	$414.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $94.50	Professional	50	$94.50	$94.50	$94.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.95 / $166.95 / $166.95	Facility		$166.95	$166.95	$166.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $153.36 / $453.86	Professional		$87.40	$153.36	$453.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $106.29 / $190.76 / $334.84	Facility		$106.29	$190.76	$334.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $234.50 / $332.50 / $556.40	Professional		$234.50	$332.50	$556.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.98 / $236.98 / $3,495.87	Facility		$236.98	$236.98	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.75 / $274.82 / $393.89	Professional		$179.75	$274.82	$393.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $86.75 / $189.98 / $334.84	Facility		$86.75	$189.98	$334.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.30 / $242.04 / $364.08	Professional		$120.30	$242.04	$364.08
United Facility/Professional Professional Modifier Low / Median / High Price $263.70 / $301.95 / $370.20	Professional		$263.70	$301.95	$370.20