Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.50 / $202.50 / $202.50	Professional		$202.50	$202.50	$202.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $202.50 / $283.50	Facility		$150.00	$202.50	$283.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,495.87 / $3,495.87 / $3,495.87	Facility		$3,495.87	$3,495.87	$3,495.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $202.50 / $300.00	Facility		$150.00	$202.50	$300.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $165.00 / $225.00	Professional		$127.50	$165.00	$225.00
United Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $225.00 / $450.00	Professional		$225.00	$225.00	$450.00