Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $501.19 / $501.19	Facility		$89.13	$501.19	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $141.25	Professional		$75.86	$75.86	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $245.47	Professional		$75.86	$75.86	$245.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $134.90 / $208.93	Facility		$75.86	$134.90	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $204.17	Facility		$141.25	$141.25	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $83.18	Professional		$60.26	$75.86	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $154.88	Professional		$75.86	$114.82	$154.88