Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $151.36	Professional		$60.26	$60.26	$151.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $251.19 / $251.19	Facility		$95.50	$251.19	$251.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26