Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.93 / $52.93 / $52.93	Professional		$52.93	$52.93	$52.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $24.24 / $24.24	Professional		$24.24	$24.24	$24.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $16.27 / $16.27 / $16.27	Facility		$16.27	$16.27	$16.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $52.38 / $52.38	Professional		$52.38	$52.38	$52.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.29 / $48.29 / $48.29	Facility		$48.29	$48.29	$48.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $48.29 / $48.29	Professional		$48.29	$48.29	$48.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.27 / $16.27 / $16.27	Facility		$16.27	$16.27	$16.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $48.29 / $54.50	Professional		$24.24	$48.29	$54.50
United Facility/Professional Professional Modifier Low / Median / High Price $33.59 / $69.98 / $117.58	Professional		$33.59	$69.98	$117.58