Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $67.61	Professional		$54.95	$57.54	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $93.33 / $128.82	Facility		$58.88	$93.33	$128.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $93.33	Professional		$54.95	$57.54	$93.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $109.65 / $3,467.37	Facility		$95.50	$109.65	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $83.18	Professional		$69.18	$75.86	$83.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $75.86 / $128.82	Facility		$58.88	$75.86	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $87.10	Professional		$58.88	$58.88	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $208.93	Professional		$69.18	$102.33	$208.93