Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.61 / $256.61 / $907.20	Facility		$256.61	$256.61	$907.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.36 / $259.20 / $259.20	Professional		$159.36	$259.20	$259.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $370.66 / $370.66 / $370.66	Facility		$370.66	$370.66	$370.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $268.80 / $268.80 / $422.40	Facility		$268.80	$268.80	$422.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $268.80 / $370.66 / $633.60	Facility		$268.80	$370.66	$633.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $240.00 / $322.75	Professional		$160.00	$240.00	$322.75