Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $239.88 / $239.88	Facility		$40.74	$239.88	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $43.65	Professional		$36.31	$36.31	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Professional		$36.31	$36.31	$36.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $43.65 / $91.20	Facility		$36.31	$43.65	$91.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $91.20	Professional		$36.31	$45.71	$91.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $58.88 / $93.33	Facility		$36.31	$58.88	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $50.12	Professional		$41.69	$50.12	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $48.98 / $67.61	Facility		$36.31	$48.98	$67.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $60.26	Professional		$36.31	$36.31	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $102.33	Professional		$36.31	$54.95	$102.33