Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $315.27 / $733.58 / $7,920.26	Facility		$315.27	$733.58	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $273.55 / $318.70 / $401.32	Facility	54	$273.55	$318.70	$401.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.69 / $222.26 / $649.36	Professional		$143.69	$222.26	$649.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.23 / $383.43 / $577.55	Professional		$244.23	$383.43	$577.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $297.75 / $408.29 / $502.51	Professional		$297.75	$408.29	$502.51
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $224.65 / $300.72 / $495.51	Facility		$224.65	$300.72	$495.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $296.75 / $343.71 / $589.91	Professional		$296.75	$343.71	$589.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.69 / $260.55 / $420.84	Facility		$169.69	$260.55	$420.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $224.65 / $319.47 / $546.61	Facility		$224.65	$319.47	$546.61
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $406.00 / $406.00 / $406.00	Facility	54	$406.00	$406.00	$406.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $310.50 / $399.99 / $553.54	Professional		$310.50	$399.99	$553.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $900.57 / $1,208.00 / $1,492.71	Facility		$900.57	$1,208.00	$1,492.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $336.42 / $438.20 / $630.25	Professional		$336.42	$438.20	$630.25
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.58 / $387.27 / $617.04	Professional		$280.58	$387.27	$617.04