Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $354.81 / $354.81	Facility		$63.10	$354.81	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $100.00	Professional		$53.70	$53.70	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $173.78	Professional		$54.95	$54.95	$173.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $95.50 / $151.36	Facility		$54.95	$95.50	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $144.54	Facility		$102.33	$102.33	$144.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $60.26	Professional		$54.95	$58.88	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $5,128.61	Professional		$54.95	$81.28	$5,128.61