Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $70.00	Facility		$50.00	$50.00	$70.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,495.87 / $3,495.87 / $3,495.87	Facility		$3,495.87	$3,495.87	$3,495.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $70.00	Facility		$50.00	$50.00	$70.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,250,000.00 / $2,250,000.00 / $2,250,000.00	Professional		$2,250,000.00	$2,250,000.00	$2,250,000.00