Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.69 / $504.49 / $504.49	Facility		$142.69	$504.49	$504.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $76.30 / $129.02	Professional		$29.53	$76.30	$129.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $69.37	Professional		$69.37	$69.37	$69.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $73.53 / $129.02 / $184.50	Facility		$73.53	$129.02	$184.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $156.08	Professional		$69.37	$69.37	$156.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.64 / $157.08 / $246.84	Facility		$108.64	$157.08	$246.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.63 / $134.63	Professional		$112.20	$134.63	$134.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.37 / $129.02 / $224.40	Facility		$69.37	$129.02	$224.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $72.53 / $123.42	Professional		$65.73	$72.53	$123.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.53 / $104.06 / $208.11	Professional		$73.53	$104.06	$208.11