Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.25 / $189.25 / $669.06	Facility		$189.25	$189.25	$669.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.53 / $191.16 / $191.16	Professional		$117.53	$191.16	$191.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Professional		$120.36	$120.36	$120.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $273.36 / $273.36 / $273.36	Facility		$273.36	$273.36	$273.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.24 / $198.24 / $311.52	Facility		$198.24	$198.24	$311.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $198.24 / $273.36 / $467.28	Facility		$198.24	$273.36	$467.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Professional		$120.36	$120.36	$120.36
United Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $177.00 / $238.03	Professional		$118.00	$177.00	$238.03