Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $200.00	Facility		$45.00	$45.00	$200.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $200.00 / $200.00	Professional		$45.00	$200.00	$200.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $60.00 / $200.00	Professional		$45.00	$60.00	$200.00