Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $812.83 / $1,023.29	Facility		$218.78	$812.83	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $173.78	Professional		$93.33	$93.33	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $812.83	Facility		$93.33	$93.33	$812.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $302.00	Professional		$93.33	$93.33	$302.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $154.88 / $245.47	Facility		$93.33	$154.88	$245.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $251.19	Facility		$173.78	$173.78	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $95.50 / $102.33	Professional		$60.26	$95.50	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $3,388.44	Professional		$93.33	$141.25	$3,388.44