Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.39 / $127.39 / $127.39	Professional		$127.39	$127.39	$127.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Facility		$68.48	$68.48	$68.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $96.92	Professional		$68.48	$68.48	$96.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $127.39 / $178.35	Facility		$68.48	$127.39	$178.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $119.86	Professional		$68.48	$68.48	$119.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.00 / $96.00 / $3,495.87	Facility		$84.00	$96.00	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $72.00 / $72.36	Professional		$60.00	$72.00	$72.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $127.39 / $178.35	Facility		$68.48	$127.39	$178.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $74.30 / $94.88	Professional		$66.00	$74.30	$94.88
United Facility/Professional Professional Modifier Low / Median / High Price $102.74 / $104.63 / $205.47	Professional		$102.74	$104.63	$205.47