Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $932.54 / $6,479.00 / $13,413.92	Facility		$932.54	$6,479.00	$13,413.92
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $654.97 / $654.97 / $699.40	Facility	54	$654.97	$654.97	$699.40
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $130.99 / $130.99 / $139.88	Facility	55	$130.99	$130.99	$139.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.77 / $361.81 / $1,791.11	Professional		$251.77	$361.81	$1,791.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $434.61 / $493.94 / $502.89	Professional	50	$434.61	$493.94	$502.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $1,241.96 / $1,258.01 / $1,343.33	Professional	54	$1,241.96	$1,258.01	$1,343.33
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $251.60 / $251.60 / $268.67	Professional	55	$251.60	$251.60	$268.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.47 / $478.47 / $1,055.33	Professional		$478.47	$478.47	$1,055.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $375.23 / $461.82 / $2,561.29	Facility		$375.23	$461.82	$2,561.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $747.20 / $959.73 / $1,730.75	Professional		$747.20	$959.73	$1,730.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,106.25 / $1,347.30 / $1,739.00	Professional		$1,106.25	$1,347.30	$1,739.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $461.82 / $496.45 / $2,561.29	Facility		$461.82	$496.45	$2,561.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $362.00 / $1,453.65 / $2,026.80	Professional		$362.00	$1,453.65	$2,026.80
United Facility/Professional Professional Modifier Low / Median / High Price $370.89 / $844.26 / $2,556.55	Professional		$370.89	$844.26	$2,556.55