Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.53 / $99.53 / $99.53	Professional		$99.53	$99.53	$99.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $45.55 / $45.55	Professional		$45.55	$45.55	$45.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.56 / $30.56 / $30.56	Facility		$30.56	$30.56	$30.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.48 / $98.48 / $98.48	Professional		$98.48	$98.48	$98.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.76 / $90.76 / $90.76	Facility		$90.76	$90.76	$90.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $90.76 / $90.76	Professional		$90.76	$90.76	$90.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.56 / $30.56 / $30.56	Facility		$30.56	$30.56	$30.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $90.76 / $102.38	Professional		$45.55	$90.76	$102.38
United Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $120.99 / $220.94	Professional		$61.16	$120.99	$220.94