Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.50 / $2,464.00 / $11,709.00	Facility		$337.50	$2,464.00	$11,709.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $262.50 / $262.50 / $711.85	Facility	54	$262.50	$262.50	$711.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.37 / $495.40 / $1,686.33	Professional		$247.37	$495.40	$1,686.33
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $226.82 / $1,157.81 / $1,706.60	Professional	54	$226.82	$1,157.81	$1,706.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $760.13 / $988.26 / $1,506.20	Professional		$760.13	$988.26	$1,506.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $302.42 / $1,543.75 / $2,253.67	Facility		$302.42	$1,543.75	$2,253.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $835.35 / $1,045.10 / $2,100.15	Professional		$835.35	$1,045.10	$2,100.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,154.40 / $1,562.50 / $1,970.91	Professional		$1,154.40	$1,562.50	$1,970.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $316.27 / $1,543.75 / $2,253.67	Facility		$316.27	$1,543.75	$2,253.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $658.00 / $1,562.50 / $1,978.20	Professional		$658.00	$1,562.50	$1,978.20
United Facility/Professional Professional Modifier Low / Median / High Price $826.92 / $1,653.84 / $1,819.22	Professional		$826.92	$1,653.84	$1,819.22