Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $478.63 / $478.63	Facility		$79.43	$478.63	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $89.13	Professional		$72.44	$72.44	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $81.28 / $186.21	Facility		$74.13	$81.28	$186.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $186.21	Professional		$74.13	$87.10	$186.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $186.21	Facility		$74.13	$117.49	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $100.00	Professional		$83.18	$100.00	$100.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $95.50 / $138.04	Facility		$74.13	$95.50	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $95.50	Professional		$74.13	$74.13	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $208.93	Professional		$74.13	$109.65	$208.93