Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.75 / $60.75 / $60.75	Professional		$60.75	$60.75	$60.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $38.25 / $38.25	Professional		$38.25	$38.25	$38.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $86.87 / $86.87 / $86.87	Facility		$86.87	$86.87	$86.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.73 / $106.73 / $152.47	Professional		$106.73	$106.73	$152.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $63.00 / $99.00	Facility		$63.00	$63.00	$99.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $86.87 / $148.50	Facility		$63.00	$86.87	$148.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $38.25 / $152.47	Professional		$38.25	$38.25	$152.47
United Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $56.25 / $75.65	Professional		$37.50	$56.25	$75.65