Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $615.29 / $3,152.56 / $9,285.00	Facility		$615.29	$3,152.56	$9,285.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $875.08 / $3,919.02 / $5,100.30	Facility	50	$875.08	$3,919.02	$5,100.30
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $65.65 / $65.65 / $134.87	Facility	53	$65.65	$65.65	$134.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.94 / $542.30 / $2,784.60	Professional		$101.94	$542.30	$2,784.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $339.61 / $4,370.62 / $4,530.33	Professional	50	$339.61	$4,370.62	$4,530.33
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.39 / $108.46 / $222.81	Professional	53	$20.39	$108.46	$222.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.33 / $470.98 / $1,066.95	Professional		$283.33	$470.98	$1,066.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $139.59 / $542.30 / $1,559.64	Facility		$139.59	$542.30	$1,559.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $269.27 / $598.73 / $1,423.50	Professional		$269.27	$598.73	$1,423.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.25 / $650.00 / $1,244.00	Professional		$416.25	$650.00	$1,244.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $139.59 / $596.54 / $1,559.64	Facility		$139.59	$596.54	$1,559.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $241.50 / $617.50 / $1,244.00	Professional		$241.50	$617.50	$1,244.00
United Facility/Professional Professional Modifier Low / Median / High Price $589.54 / $889.38 / $1,341.20	Professional		$589.54	$889.38	$1,341.20