Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $886.34 / $3,677.86 / $9,285.00	Facility		$886.34	$3,677.86	$9,285.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,491.25 / $3,491.25 / $3,491.25	Facility	22	$3,491.25	$3,491.25	$3,491.25
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $374.99 / $374.99 / $635.61	Facility	52	$374.99	$374.99	$635.61
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $150.00 / $150.00 / $254.24	Facility	53	$150.00	$150.00	$254.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.17 / $571.00 / $2,324.03	Professional		$265.17	$571.00	$2,324.03
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $50.98 / $97.19 / $464.81	Professional	53	$50.98	$97.19	$464.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.72 / $608.08 / $1,414.10	Professional		$342.72	$608.08	$1,414.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $315.68 / $1,371.11 / $3,253.64	Facility		$315.68	$1,371.11	$3,253.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $678.71 / $1,401.92 / $2,943.22	Professional		$678.71	$1,401.92	$2,943.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $878.00 / $1,636.81 / $2,760.74	Professional		$878.00	$1,636.81	$2,760.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $315.68 / $1,371.11 / $3,253.64	Facility		$315.68	$1,371.11	$3,253.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $506.95 / $1,303.75 / $2,633.76	Professional		$506.95	$1,303.75	$2,633.76
United Facility/Professional Professional Modifier Low / Median / High Price $699.34 / $1,131.28 / $3,120.45	Professional		$699.34	$1,131.28	$3,120.45