Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $134.90	Professional		$72.44	$72.44	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $87.10	Facility		$72.44	$72.44	$87.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $234.42	Professional		$72.44	$72.44	$234.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $123.03 / $190.55	Facility		$72.44	$123.03	$190.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $194.98	Facility		$134.90	$134.90	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $79.43	Professional		$60.26	$67.61	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $147.91	Professional		$72.44	$109.65	$147.91