Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $135.00 / $135.00	Professional		$135.00	$135.00	$135.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $135.00 / $189.00	Facility		$100.00	$135.00	$189.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $201.15 / $201.15 / $201.15	Professional		$201.15	$201.15	$201.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $160.00 / $3,495.87	Facility		$140.00	$160.00	$3,495.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $110.00 / $120.00	Professional		$85.00	$110.00	$120.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $135.00 / $200.00	Facility		$100.00	$135.00	$200.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $120.00 / $125.00	Professional		$85.00	$120.00	$125.00
United Facility/Professional Professional Modifier Low / Median / High Price $241.38 / $241.38 / $482.76	Professional		$241.38	$241.38	$482.76