Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,288.25 / $1,288.25	Facility		$204.17	$1,288.25	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $234.42	Professional		$194.98	$194.98	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $234.42 / $489.78	Facility		$194.98	$234.42	$489.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $489.78	Professional		$194.98	$234.42	$489.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $302.00 / $467.74	Facility		$194.98	$302.00	$467.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $257.04	Professional		$213.80	$257.04	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $257.04 / $363.08	Facility		$194.98	$257.04	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $251.19	Professional		$194.98	$194.98	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $549.54	Professional		$194.98	$295.12	$549.54