Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $1,288.25 / $1,288.25	Facility		$208.93	$1,288.25	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $363.08	Professional		$194.98	$194.98	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $630.96	Professional		$194.98	$194.98	$630.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $309.03 / $478.63	Facility		$194.98	$309.03	$478.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $524.81	Facility		$363.08	$363.08	$524.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $199.53 / $213.80	Professional		$60.26	$199.53	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $398.11	Professional		$194.98	$295.12	$398.11