Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $831.76 / $5,495.41	Facility		$794.33	$831.76	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $851.14	Professional		$269.15	$467.74	$851.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $1,148.15 / $1,174.90	Professional	50	$1,148.15	$1,148.15	$1,174.90
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $371.54 / $758.58	Professional	54	$288.40	$371.54	$758.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $323.59 / $707.95	Facility		$112.20	$323.59	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $660.69 / $707.95	Professional		$562.34	$660.69	$707.95
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $831.76 / $977.24 / $1,047.13	Professional	50	$831.76	$977.24	$1,047.13
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $512.86 / $588.84 / $630.96	Professional	54	$512.86	$588.84	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $575.44	Professional		$309.03	$446.68	$575.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $478.63 / $812.83	Facility		$316.23	$478.63	$812.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $660.69 / $831.76	Professional		$426.58	$660.69	$831.76
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $1,148.15 / $1,174.90	Professional	50	$1,148.15	$1,148.15	$1,174.90
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $371.54 / $758.58	Professional	54	$288.40	$371.54	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $549.54 / $741.31	Facility		$426.58	$549.54	$741.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $645.65 / $724.44	Professional		$446.68	$645.65	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $380.19 / $741.31	Professional		$316.23	$380.19	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,819.70 / $9,332.54	Facility		$151.36	$1,819.70	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $457.09 / $660.69	Professional		$302.00	$457.09	$660.69