Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,122.02 / $1,122.02	Facility		$177.83	$1,122.02	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Professional		$173.78	$173.78	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $194.98 / $436.52	Facility		$173.78	$194.98	$436.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $436.52	Professional		$173.78	$208.93	$436.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $302.00 / $478.63	Facility		$173.78	$302.00	$478.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $263.03	Professional		$218.78	$263.03	$263.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $190.55 / $316.23	Facility		$100.00	$190.55	$316.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $223.87	Professional		$173.78	$173.78	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $489.78	Professional		$173.78	$263.03	$489.78