Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $194.98 / $309.03	Facility		$109.65	$194.98	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $22.91 / $83.18	Professional		$19.95	$22.91	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $25.12 / $120.23	Facility		$19.95	$25.12	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $56.23 / $81.28	Professional		$25.12	$56.23	$81.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $93.33 / $100.00	Facility		$87.10	$93.33	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $25.12 / $120.23	Facility		$19.95	$25.12	$120.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $27.54 / $60.26	Professional		$25.12	$27.54	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $75.86	Professional		$27.54	$50.12	$75.86