Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $4,466.84 / $4,466.84	Facility		$724.44	$4,466.84	$4,466.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $831.76	Professional		$691.83	$691.83	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $831.76 / $1,698.24	Facility		$691.83	$831.76	$1,698.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $831.76 / $1,698.24	Professional		$691.83	$831.76	$1,698.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,096.48 / $1,737.80	Facility		$691.83	$1,096.48	$1,737.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $933.25 / $933.25	Professional		$776.25	$933.25	$933.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $891.25 / $1,288.25	Facility		$691.83	$891.25	$1,288.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $870.96	Professional		$691.83	$691.83	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,023.29 / $1,905.46	Professional		$691.83	$1,023.29	$1,905.46