Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.93 / $166.93 / $166.93	Professional		$166.93	$166.93	$166.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $127.00	Professional		$89.75	$89.75	$127.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $166.93 / $238.71	Facility		$82.41	$166.93	$238.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $116.68	Professional		$89.75	$89.75	$116.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.82 / $2,668.80 / $3,669.60	Facility		$110.82	$2,668.80	$3,669.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,384.44 / $1,834.80 / $2,001.60	Professional		$1,384.44	$1,834.80	$2,001.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $166.93 / $1,834.80	Facility		$89.75	$166.93	$1,834.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.22 / $97.37 / $840.00	Professional		$81.22	$97.37	$840.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.63 / $134.63 / $269.25	Professional		$134.63	$134.63	$269.25