Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $123.03 / $123.03	Facility		$20.42	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $34.67	Professional		$19.05	$19.05	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Professional		$19.05	$19.05	$19.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $61.66	Professional		$19.05	$19.05	$61.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $30.20 / $47.86	Facility		$19.05	$30.20	$47.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Professional		$18.20	$18.20	$18.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $50.12	Facility		$35.48	$35.48	$50.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $20.42 / $60.26	Professional		$19.50	$20.42	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.84 / $38.02	Professional		$19.05	$28.84	$38.02