Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.01 / $90.01 / $90.01	Professional		$90.01	$90.01	$90.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $47.91 / $47.91	Professional		$47.91	$47.91	$47.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Facility		$19.32	$19.32	$19.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.01 / $156.24 / $169.26	Professional		$123.01	$156.24	$169.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.22 / $70.22 / $217.35	Facility		$70.22	$70.22	$217.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $201.25 / $296.39	Professional		$70.22	$201.25	$296.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Facility		$19.32	$19.32	$19.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $201.25 / $264.25	Professional		$47.91	$201.25	$264.25
United Facility/Professional Professional Modifier Low / Median / High Price $137.86 / $137.86 / $343.92	Professional		$137.86	$137.86	$343.92