Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Facility		$44.67	$44.67	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $69.18	Facility		$44.67	$44.67	$69.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $74.13	Facility		$44.67	$44.67	$74.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $275.42 / $275.42	Professional		$79.43	$275.42	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78