Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $400.95 / $1,417.50 / $1,417.50	Facility		$400.95	$1,417.50	$1,417.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.00 / $405.00 / $405.00	Professional		$405.00	$405.00	$405.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Facility		$255.00	$255.00	$255.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $63.84 / $91.20	Professional		$63.84	$63.84	$91.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $249.00 / $480.00 / $660.00	Facility		$249.00	$480.00	$660.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.00 / $300.00 / $360.00	Professional		$249.00	$300.00	$360.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $600.00	Facility		$255.00	$255.00	$600.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $255.00 / $330.00	Professional		$63.84	$255.00	$330.00
United Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $375.00 / $504.30	Professional		$375.00	$375.00	$504.30