Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,836.00 / $10,480.00 / $13,413.92	Facility		$8,836.00	$10,480.00	$13,413.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.96 / $565.54 / $565.54	Professional		$350.96	$565.54	$565.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $480.71 / $565.54 / $791.76	Facility		$480.71	$565.54	$791.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,629.00 / $1,964.75 / $3,176.55	Professional		$1,629.00	$1,964.75	$3,176.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $480.71 / $565.54 / $791.76	Facility		$480.71	$565.54	$791.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,620.00 / $2,443.50 / $3,722.27	Professional		$1,620.00	$2,443.50	$3,722.27
United Facility/Professional Professional Modifier Low / Median / High Price $1,477.30 / $2,585.28 / $3,250.06	Professional		$1,477.30	$2,585.28	$3,250.06