Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.63 / $541.29 / $1,087.58	Facility		$307.63	$541.29	$1,087.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.73 / $317.08 / $1,124.66	Professional		$168.73	$317.08	$1,124.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $453.44 / $453.44 / $453.44	Facility		$453.44	$453.44	$453.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $548.95	Professional		$170.48	$170.48	$548.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $745.90 / $798.66 / $1,255.03	Facility		$745.90	$798.66	$1,255.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $453.44 / $798.66 / $1,882.55	Facility		$453.44	$798.66	$1,882.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $184.95	Professional		$170.48	$170.48	$184.95
United Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $255.72 / $343.89	Professional		$170.48	$255.72	$343.89