Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $628.95 / $628.95 / $628.95	Professional		$628.95	$628.95	$628.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.52 / $289.52 / $289.52	Professional		$289.52	$289.52	$289.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $269.06 / $338.54 / $417.41	Facility		$269.06	$338.54	$417.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $468.86 / $468.86 / $1,445.85	Facility		$468.86	$468.86	$1,445.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $468.86 / $1,355.00 / $2,018.25	Professional		$468.86	$1,355.00	$2,018.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $269.06 / $350.48 / $429.32	Facility		$269.06	$350.48	$429.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $289.52 / $1,338.75 / $1,811.25	Professional		$289.52	$1,338.75	$1,811.25
United Facility/Professional Professional Modifier Low / Median / High Price $814.68 / $817.46 / $1,990.52	Professional		$814.68	$817.46	$1,990.52