Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $10.72 / $15.14	Professional		$8.91	$10.72	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $10.00	Professional		$10.00	$10.00	$10.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $22.91 / $54.95	Facility		$15.85	$22.91	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $10.47 / $60.26	Professional		$7.24	$10.47	$60.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $16.60 / $25.70	Facility		$16.60	$16.60	$25.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $11.22	Professional		$11.22	$11.22	$11.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $22.91	Facility		$15.85	$15.85	$22.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $10.00 / $60.26	Professional		$7.24	$10.00	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $14.79 / $194.98	Professional		$9.77	$14.79	$194.98