Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $450.00 / $495.00	Professional		$450.00	$450.00	$495.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $258.52 / $258.52	Professional		$258.52	$258.52	$258.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $630.00	Facility		$450.00	$450.00	$630.00
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 $450.00 / $450.00 / $630.00	Facility		$450.00	$450.00	$630.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $258.52 / $2,250,000.00	Professional		$258.52	$258.52	$2,250,000.00