Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.63 / $180.63 / $180.63	Professional		$180.63	$180.63	$180.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $96.42 / $96.42	Facility		$96.42	$96.42	$96.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $96.42 / $96.42	Professional		$81.96	$96.42	$96.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.07 / $80.65 / $121.70	Facility		$52.07	$80.65	$121.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $135.00 / $180.00	Professional		$15.96	$135.00	$180.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $116.01 / $213.47	Professional		$13.73	$116.01	$213.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.31 / $81.73 / $120.03	Facility		$56.31	$81.73	$120.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $96.42 / $96.42	Professional		$81.96	$96.42	$96.42
United Facility/Professional Professional Modifier Low / Median / High Price $82.38 / $157.90 / $314.39	Professional		$82.38	$157.90	$314.39