Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $3,890.45	Professional		$1,737.80	$1,737.80	$3,890.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,570.40	Facility		$1,737.80	$1,737.80	$2,570.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,737.80 / $1,737.80	Professional		$79.43	$1,737.80	$1,737.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,570.40	Facility		$1,737.80	$1,737.80	$2,570.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43