Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $42.39 / $49.20	Professional		$27.26	$42.39	$49.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $36.29 / $36.29	Professional		$36.29	$36.29	$36.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.03 / $49.20 / $142.68	Facility		$30.03	$49.20	$142.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $43.89 / $62.70	Professional		$43.89	$43.89	$62.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.60 / $165.00 / $250.80	Professional		$105.60	$165.00	$250.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.03 / $49.20 / $142.68	Facility		$30.03	$49.20	$142.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $139.91 / $257.39	Professional		$36.29	$139.91	$257.39
United Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $31.96 / $113.41	Professional		$23.82	$31.96	$113.41