Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $114.82 / $114.82	Facility		$20.42	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $17.78 / $33.11	Professional		$16.98	$17.78	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Professional		$17.78	$17.78	$17.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Facility		$17.78	$17.78	$17.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $57.54	Professional		$17.78	$17.78	$57.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $34.67 / $54.95	Facility		$17.78	$34.67	$54.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Professional		$18.20	$18.20	$18.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $47.86	Facility		$33.11	$33.11	$47.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $19.50 / $60.26	Professional		$17.38	$19.50	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $26.92 / $36.31	Professional		$17.78	$26.92	$36.31