Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $162.18	Professional		$87.10	$87.10	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $104.71	Facility		$87.10	$87.10	$104.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $281.84	Professional		$87.10	$87.10	$281.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $147.91 / $234.42	Facility		$144.54	$147.91	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $234.42	Facility		$162.18	$162.18	$234.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $95.50	Professional		$60.26	$87.10	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $177.83	Professional		$87.10	$131.83	$177.83