Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.41 / $70.68 / $128.83	Professional		$55.41	$70.68	$128.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $61.30 / $61.30	Professional		$61.30	$61.30	$61.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $128.83 / $180.36	Facility		$73.56	$128.83	$180.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.71 / $199.89 / $315.04	Professional		$128.71	$199.89	$315.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $278.10	Facility		$94.22	$94.22	$278.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.35 / $258.30 / $376.98	Professional		$137.35	$258.30	$376.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.23 / $128.83 / $180.36	Facility		$65.23	$128.83	$180.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $167.15 / $358.75	Professional		$63.13	$167.15	$358.75
United Facility/Professional Professional Modifier Low / Median / High Price $110.34 / $203.38 / $406.76	Professional		$110.34	$203.38	$406.76