Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,047.13 / $18,620.87	Facility		$302.00	$1,047.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $194.98	Professional		$162.18	$162.18	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $407.38	Facility		$162.18	$194.98	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $407.38	Professional		$162.18	$194.98	$407.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $588.84 / $912.01	Facility		$162.18	$588.84	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $501.19 / $501.19	Professional		$416.87	$501.19	$501.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $457.09	Facility		$162.18	$194.98	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $186.21	Professional		$134.90	$134.90	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $457.09	Professional		$162.18	$245.47	$457.09