Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.73 / $253.73 / $253.73	Facility		$253.73	$253.73	$253.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.10 / $41.64 / $74.94	Professional		$30.10	$41.64	$74.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $28.57 / $28.57	Professional		$28.57	$28.57	$28.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $34.49 / $65.51 / $104.92	Facility		$34.49	$65.51	$104.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $84.95 / $138.29	Professional		$66.30	$84.95	$138.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.35 / $109.35 / $3,495.87	Facility		$109.35	$109.35	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.80 / $109.35 / $156.00	Professional		$57.80	$109.35	$156.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.76 / $65.51 / $104.92	Facility		$32.76	$65.51	$104.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $78.84 / $152.10	Professional		$38.77	$78.84	$152.10
United Facility/Professional Professional Modifier Low / Median / High Price $74.64 / $85.98 / $178.41	Professional		$74.64	$85.98	$178.41