Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $625.40 / $2,084.67 / $3,823.88	Facility		$625.40	$2,084.67	$3,823.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $595.62 / $595.62 / $595.62	Professional		$595.62	$595.62	$595.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $355.84 / $476.71 / $580.09	Facility		$355.84	$476.71	$580.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $551.67 / $1,892.80 / $2,438.80	Professional		$551.67	$1,892.80	$2,438.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $355.84 / $476.71 / $580.09	Facility		$355.84	$476.71	$580.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $551.67 / $2,184.00 / $3,326.96	Professional		$551.67	$2,184.00	$3,326.96
United Facility/Professional Professional Modifier Low / Median / High Price $772.56 / $1,281.76 / $1,922.64	Professional		$772.56	$1,281.76	$1,922.64