Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $128.86	Professional		$20.00	$20.00	$128.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $25.00 / $58.00	Facility		$20.00	$25.00	$58.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $287.66 / $287.66 / $287.66	Professional		$287.66	$287.66	$287.66
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 $20.00 / $21.00 / $30.60	Facility		$20.00	$21.00	$30.60