Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $20.89 / $38.02	Professional		$19.95	$20.89	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $20.89 / $20.89	Professional		$19.95	$20.89	$20.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $26.30 / $52.48	Facility		$20.89	$26.30	$52.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $67.61	Professional		$20.89	$26.30	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $120.23 / $190.55	Facility		$20.89	$120.23	$190.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $102.33 / $102.33	Professional		$85.11	$102.33	$102.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $33.11 / $95.50	Facility		$20.89	$33.11	$95.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $57.54	Professional		$20.42	$20.42	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $31.62 / $58.88	Professional		$20.89	$31.62	$58.88