Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $680.34 / $6,541.00 / $13,413.92	Facility		$680.34	$6,541.00	$13,413.92
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $504.55 / $504.55 / $510.26	Facility	54	$504.55	$504.55	$510.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.17 / $1,140.97 / $1,153.89	Professional		$220.17	$1,140.97	$1,153.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $558.04 / $732.15 / $1,062.76	Professional		$558.04	$732.15	$1,062.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $222.43 / $1,140.97 / $1,615.45	Facility		$222.43	$1,140.97	$1,615.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $605.70 / $731.67 / $1,475.53	Professional		$605.70	$731.67	$1,475.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $820.00 / $1,142.08 / $1,434.40	Professional		$820.00	$1,142.08	$1,434.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $230.13 / $1,140.97 / $1,615.45	Facility		$230.13	$1,140.97	$1,615.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $459.20 / $1,137.50 / $1,434.40	Professional		$459.20	$1,137.50	$1,434.40
United Facility/Professional Professional Modifier Low / Median / High Price $308.83 / $887.27 / $1,293.91	Professional		$308.83	$887.27	$1,293.91