Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $36.39 / $128.66	Facility		$35.11	$36.39	$128.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $23.91 / $40.36	Professional		$21.70	$23.91	$40.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $26.61	Professional		$21.70	$21.70	$26.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $40.36 / $122.09	Facility		$21.92	$40.36	$122.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $48.83	Professional		$21.70	$21.70	$48.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.50 / $112.67 / $177.06	Facility		$35.50	$112.67	$177.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $96.58 / $96.58	Professional		$80.48	$96.58	$96.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.70 / $40.36 / $127.14	Facility		$21.70	$40.36	$127.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $29.33 / $80.48	Professional		$21.70	$29.33	$80.48
United Facility/Professional Professional Modifier Low / Median / High Price $23.00 / $32.54 / $65.09	Professional		$23.00	$32.54	$65.09