Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $781.92 / $781.92 / $781.92	Professional		$781.92	$781.92	$781.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $254.95 / $254.95 / $1,118.15	Facility		$254.95	$254.95	$1,118.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $609.00 / $920.70 / $1,219.16	Professional		$609.00	$920.70	$1,219.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $781.92 / $1,071.23 / $1,118.15	Facility		$781.92	$1,071.23	$1,118.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $599.87 / $913.50 / $1,171.72	Professional		$599.87	$913.50	$1,171.72
United Facility/Professional Professional Modifier Low / Median / High Price $324.92 / $803.91 / $1,284.77	Professional		$324.92	$803.91	$1,284.77