Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.81 / $181.45 / $259.76	Professional		$67.81	$181.45	$259.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $68.73 / $68.73	Professional		$68.73	$68.73	$68.73
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $159.25 / $259.76 / $363.66	Facility		$159.25	$259.76	$363.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $118.75 / $121.33	Professional		$83.13	$118.75	$121.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $337.50 / $337.50 / $3,495.87	Facility		$337.50	$337.50	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.75 / $315.00 / $445.00	Professional		$163.75	$315.00	$445.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $259.76 / $363.66	Facility		$140.00	$259.76	$363.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $118.75 / $2,400,000.00	Professional		$68.73	$118.75	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $169.20 / $188.00 / $484.27	Professional		$169.20	$188.00	$484.27