Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.84 / $68.84 / $68.84	Professional		$68.84	$68.84	$68.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.50 / $21.50 / $25.43	Professional		$21.50	$21.50	$25.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.37 / $68.84 / $96.39	Facility		$54.37	$68.84	$96.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $59.20 / $68.72 / $186.96	Professional		$59.20	$68.72	$186.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.64 / $70.64 / $3,495.87	Facility		$70.64	$70.64	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.67 / $70.64 / $70.64	Professional		$50.67	$70.64	$70.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.63 / $68.84 / $96.39	Facility		$54.63	$68.84	$96.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $57.47 / $73.03	Professional		$25.43	$57.47	$73.03
United Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $37.76 / $180.45	Professional		$34.96	$37.76	$180.45