Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.27 / $192.59 / $680.86	Facility		$145.27	$192.59	$680.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $126.54 / $166.18	Professional		$89.34	$126.54	$166.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $109.57	Professional		$89.34	$89.34	$109.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $94.70 / $166.18 / $237.64	Facility		$94.70	$166.18	$237.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $201.02	Professional		$89.34	$89.34	$201.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.23 / $215.88 / $339.24	Facility		$201.23	$215.88	$339.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.19 / $185.04 / $185.04	Professional		$154.19	$185.04	$185.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $166.18 / $321.48	Facility		$89.34	$166.18	$321.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $162.94 / $192.89	Professional		$89.34	$162.94	$192.89
United Facility/Professional Professional Modifier Low / Median / High Price $94.70 / $134.01 / $268.02	Professional		$94.70	$134.01	$268.02