Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $1,174.90 / $1,479.11	Professional		$380.19	$1,174.90	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,659.59	Professional		$1,174.90	$1,174.90	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,187.76 / $3,090.30	Facility		$1,412.54	$2,187.76	$3,090.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $309.03 / $512.86	Professional		$169.82	$309.03	$512.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,137.96 / $3,467.37	Facility		$1,778.28	$2,137.96	$3,467.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,445.44 / $1,584.89	Professional		$1,318.26	$1,445.44	$1,584.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,479.11 / $2,398.83	Facility		$177.83	$1,479.11	$2,398.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $562.34	Professional		$125.89	$125.89	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $446.68 / $2,818.38	Professional		$190.55	$446.68	$2,818.38