Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.11 / $164.46 / $193.49	Facility		$145.11	$164.46	$193.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.09 / $131.57 / $193.41	Professional		$116.09	$131.57	$193.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.01 / $272.01 / $272.01	Professional		$272.01	$272.01	$272.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.18 / $80.25 / $107.91	Facility		$57.18	$80.25	$107.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $195.85 / $227.07 / $245.99	Professional		$195.85	$227.07	$245.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.57 / $100.57 / $191.06	Facility		$100.57	$100.57	$191.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.57 / $199.80 / $292.50	Professional		$100.57	$199.80	$292.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.45 / $81.53 / $107.91	Facility		$58.45	$81.53	$107.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.57 / $209.95 / $291.25	Professional		$100.57	$209.95	$291.25
United Facility/Professional Professional Modifier Low / Median / High Price $217.62 / $219.62 / $244.82	Professional		$217.62	$219.62	$244.82