Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.74 / $152.94 / $453.60	Facility		$28.74	$152.94	$453.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $27.72 / $46.88	Professional		$25.20	$27.72	$46.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $27.43	Professional		$25.20	$25.20	$27.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.46 / $46.88 / $246.92	Facility		$25.46	$46.88	$246.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $25.20 / $50.40	Professional		$25.20	$25.20	$50.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.84 / $61.73 / $97.00	Facility		$37.84	$61.73	$97.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.09 / $52.91 / $52.91	Professional		$44.09	$52.91	$52.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.82 / $48.50 / $210.53	Facility		$38.82	$48.50	$210.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $31.15 / $44.09	Professional		$25.20	$31.15	$44.09
United Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $37.79 / $75.59	Professional		$26.71	$37.79	$75.59