Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.08 / $123.75 / $437.50	Facility		$52.08	$123.75	$437.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $92.91 / $156.66	Professional		$67.88	$92.91	$156.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $132.86 / $132.86 / $132.86	Facility		$132.86	$132.86	$132.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $160.84	Professional		$49.95	$49.95	$160.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.38 / $61.47 / $87.03	Facility		$55.38	$61.47	$87.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.38 / $79.12 / $132.86	Facility		$55.38	$79.12	$132.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $54.19	Professional		$49.95	$49.95	$54.19
United Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $74.93 / $100.76	Professional		$49.95	$74.93	$100.76