Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $78.95 / $216.48	Professional		$78.95	$78.95	$216.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $38.69 / $38.69	Professional		$38.69	$38.69	$38.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.95 / $110.53 / $173.65	Facility		$78.95	$110.53	$173.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $126.15 / $135.40	Professional		$55.10	$126.15	$135.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.65 / $170.10 / $232.05	Professional		$81.65	$170.10	$232.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.95 / $110.53 / $173.65	Facility		$78.95	$110.53	$173.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $109.82 / $265.06	Professional		$38.69	$109.82	$265.06
United Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $118.30 / $180.67	Professional		$41.68	$118.30	$180.67