Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $128.82	Professional		$69.18	$69.18	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $83.18	Facility		$69.18	$69.18	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $223.87	Professional		$69.18	$69.18	$223.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $147.91 / $234.42	Facility		$69.18	$147.91	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $186.21	Facility		$128.82	$128.82	$186.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $75.86	Professional		$60.26	$70.79	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $478.63	Professional		$77.62	$104.71	$478.63