Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $2,691.53 / $2,691.53	Facility		$138.04	$2,691.53	$2,691.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $204.17	Professional		$112.20	$112.20	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $134.90	Facility		$112.20	$112.20	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $354.81	Professional		$112.20	$112.20	$354.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $794.33 / $1,258.93	Facility		$112.20	$794.33	$1,258.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $295.12	Facility		$208.93	$208.93	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $109.65 / $120.23	Professional		$60.26	$109.65	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $457.09	Professional		$112.20	$165.96	$457.09