Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,125.00 / $8,125.00 / $8,125.00	Facility		$8,125.00	$8,125.00	$8,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $137.47 / $137.47	Professional		$137.47	$137.47	$137.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $165.00 / $165.00	Professional		$165.00	$165.00	$165.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $137.47 / $137.47 / $192.46	Facility		$137.47	$137.47	$192.46
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 $137.47 / $137.47 / $192.46	Facility		$137.47	$137.47	$192.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $165.00 / $2,250,000.00	Professional		$165.00	$165.00	$2,250,000.00