Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $1,621.81 / $1,621.81	Facility		$263.03	$1,621.81	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $426.58	Professional		$245.47	$245.47	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $295.12 / $616.60	Facility		$245.47	$295.12	$616.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $616.60	Professional		$245.47	$302.00	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $398.11 / $616.60	Facility		$245.47	$398.11	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $338.84	Professional		$281.84	$338.84	$338.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $323.59 / $457.09	Facility		$245.47	$323.59	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $323.59	Professional		$245.47	$245.47	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $691.83	Professional		$245.47	$371.54	$691.83