Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.00 / $5,328.00 / $11,709.00	Facility		$753.00	$5,328.00	$11,709.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $635.24 / $635.24 / $699.34	Facility	54	$635.24	$635.24	$699.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.88 / $323.30 / $1,581.47	Professional		$247.88	$323.30	$1,581.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $710.35 / $933.70 / $1,465.63	Professional		$710.35	$933.70	$1,465.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $289.27 / $1,436.52 / $2,214.06	Facility		$289.27	$1,436.52	$2,214.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $760.95 / $1,012.11 / $2,033.85	Professional		$760.95	$1,012.11	$2,033.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,088.09 / $1,571.50 / $1,862.00	Professional		$1,088.09	$1,571.50	$1,862.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $309.86 / $1,436.52 / $2,214.06	Facility		$309.86	$1,436.52	$2,214.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $627.75 / $1,513.05 / $1,912.55	Professional		$627.75	$1,513.05	$1,912.55
United Facility/Professional Professional Modifier Low / Median / High Price $817.96 / $1,635.92 / $1,799.51	Professional		$817.96	$1,635.92	$1,799.51