Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.53 / $247.53 / $247.53	Facility		$247.53	$247.53	$247.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.80 / $172.09 / $386.39	Professional		$135.80	$172.09	$386.39
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $256.83 / $260.77 / $260.77	Professional	25	$256.83	$260.77	$260.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $175.22 / $292.72 / $409.81	Facility		$175.22	$292.72	$409.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $401.10 / $481.32 / $742.10	Professional		$401.10	$481.32	$742.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,495.87 / $3,495.87 / $3,495.87	Facility		$3,495.87	$3,495.87	$3,495.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $158.11 / $292.72 / $409.81	Facility		$158.11	$292.72	$409.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $194.71 / $229.90	Professional		$147.60	$194.71	$229.90
United Facility/Professional Professional Modifier Low / Median / High Price $421.87 / $453.10 / $522.04	Professional		$421.87	$453.10	$522.04