Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.19 / $374.19 / $374.19	Professional		$374.19	$374.19	$374.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.39 / $172.39 / $172.39	Professional		$172.39	$172.39	$172.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $160.08 / $201.41 / $248.32	Facility		$160.08	$201.41	$248.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $279.05 / $279.05 / $859.95	Facility		$279.05	$279.05	$859.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.05 / $806.25 / $1,201.20	Professional		$279.05	$806.25	$1,201.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $160.08 / $208.51 / $255.42	Facility		$160.08	$208.51	$255.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.39 / $796.25 / $1,078.00	Professional		$172.39	$796.25	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $486.60 / $486.60 / $1,197.84	Professional		$486.60	$486.60	$1,197.84