Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.38 / $169.38 / $169.38	Professional		$169.38	$169.38	$169.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $75.09 / $75.09	Facility		$75.09	$75.09	$75.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $75.09 / $80.05	Professional		$54.82	$75.09	$80.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.70 / $38.70 / $38.70	Facility		$38.70	$38.70	$38.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.86 / $187.83 / $296.58	Professional		$130.86	$187.83	$296.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.70 / $38.70 / $75.09	Facility		$38.70	$38.70	$75.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $80.05 / $152.51	Professional		$54.82	$80.05	$152.51
United Facility/Professional Professional Modifier Low / Median / High Price $95.57 / $189.07 / $246.62	Professional		$95.57	$189.07	$246.62