Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $174.51 / $507.03	Facility		$109.28	$174.51	$507.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $48.60 / $91.00	Professional		$32.86	$48.60	$91.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $30.60 / $30.60	Professional		$30.60	$30.60	$30.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.50 / $69.50 / $69.50	Facility		$69.50	$69.50	$69.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $22.94 / $32.78	Professional		$22.94	$22.94	$32.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $50.40 / $79.20	Facility		$50.40	$50.40	$79.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $69.50 / $118.80	Facility		$50.40	$69.50	$118.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $30.60 / $32.78	Professional		$22.94	$30.60	$32.78
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $45.00 / $60.52	Professional		$30.00	$45.00	$60.52