Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $912.01 / $5,495.41	Facility		$457.09	$912.01	$5,495.41
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	50	$831.76	$831.76	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $380.19 / $954.99	Professional		$288.40	$380.19	$954.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $489.78 / $3,801.89	Professional	50	$380.19	$489.78	$3,801.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $295.12 / $346.74 / $912.01	Professional	54	$295.12	$346.74	$912.01
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.10 / $63.10 / $389.05	Professional	55	$63.10	$63.10	$389.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $812.83 / $1,513.56	Facility		$380.19	$812.83	$1,513.56
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $562.34 / $1,202.26 / $2,238.72	Facility	50	$562.34	$1,202.26	$2,238.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $660.69	Professional		$489.78	$602.56	$660.69
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $707.95 / $891.25 / $1,000.00	Professional	50	$707.95	$891.25	$1,000.00
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $446.68 / $524.81 / $588.84	Professional	54	$446.68	$524.81	$588.84
BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $50.12 / $60.26 / $66.07	Professional	55	$50.12	$60.26	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $416.87 / $575.44	Professional		$245.47	$416.87	$575.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $512.86 / $1,047.13	Facility		$269.15	$512.86	$1,047.13
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	50	$831.76	$831.76	$831.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $691.83	Professional		$295.12	$524.81	$691.83
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $331.13 / $380.19 / $724.44	Professional	50	$331.13	$380.19	$724.44
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $295.12 / $295.12 / $346.74	Professional	54	$295.12	$295.12	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $1,862.09	Facility		$1,047.13	$1,318.26	$1,862.09
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,584.89 / $2,089.30 / $2,754.23	Facility	50	$1,584.89	$2,089.30	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $691.83	Professional		$446.68	$602.56	$691.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $501.19 / $831.76	Professional		$295.12	$501.19	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $2,630.27 / $4,466.84	Facility		$346.74	$2,630.27	$4,466.84
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $616.60	Professional		$302.00	$436.52	$616.60