Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $53.68 / $53.68	Professional		$53.68	$53.68	$53.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $30.86 / $30.86	Professional		$30.86	$30.86	$30.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.60 / $53.68 / $76.76	Facility		$47.60	$53.68	$76.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $57.43 / $57.43	Professional		$57.43	$57.43	$57.43
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
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.03 / $59.03 / $59.03	Professional		$59.03	$59.03	$59.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.68 / $59.05 / $99.60	Facility		$53.68	$59.05	$99.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $52.93 / $70.84	Professional		$30.86	$52.93	$70.84
United Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $30.16 / $150.78	Professional		$29.21	$30.16	$150.78