Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $257.04 / $257.04	Facility		$57.54	$257.04	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $74.13	Professional		$38.90	$39.81	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $47.86 / $100.00	Facility		$39.81	$47.86	$100.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $109.65	Professional		$39.81	$50.12	$109.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $147.91 / $234.42	Facility		$39.81	$147.91	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $128.82	Professional		$107.15	$128.82	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $56.23 / $107.15	Facility		$39.81	$56.23	$107.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $7.94 / $70.79	Professional		$7.94	$7.94	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $112.20	Professional		$39.81	$60.26	$112.20