Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,236.00 / $10,900.00 / $17,695.00	Facility		$2,236.00	$10,900.00	$17,695.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $391.16 / $391.16 / $391.16	Facility	53	$391.16	$391.16	$391.16
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,466.84 / $1,466.84 / $1,466.84	Facility	54	$1,466.84	$1,466.84	$1,466.84
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $293.37 / $293.37 / $293.37	Facility	55	$293.37	$293.37	$293.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $670.63 / $3,756.50	Professional		$584.94	$670.63	$3,756.50
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $563.48 / $563.48 / $563.48	Professional	55	$563.48	$563.48	$563.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,282.27 / $2,282.27 / $2,282.27	Professional		$2,282.27	$2,282.27	$2,282.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $828.13 / $998.76 / $5,371.80	Facility		$828.13	$998.76	$5,371.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,641.58 / $1,969.89 / $4,736.22	Professional		$1,641.58	$1,969.89	$4,736.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,468.75 / $2,737.80 / $3,714.90	Professional		$2,468.75	$2,737.80	$3,714.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $998.76 / $998.76 / $5,371.80	Facility		$998.76	$998.76	$5,371.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $693.33 / $3,258.75 / $4,443.75	Professional		$693.33	$3,258.75	$4,443.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.94 / $1,825.82 / $5,528.88	Professional		$1,047.94	$1,825.82	$5,528.88