Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.22 / $59.22 / $59.22	Professional		$59.22	$59.22	$59.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.98 / $49.98 / $49.98	Professional		$49.98	$49.98	$49.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,495.87 / $3,495.87 / $3,495.87	Facility		$3,495.87	$3,495.87	$3,495.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,495.87 / $3,495.87 / $3,495.87	Facility		$3,495.87	$3,495.87	$3,495.87