Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.90 / $5,633.00 / $13,423.78	Facility		$904.90	$5,633.00	$13,423.78
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,047.50 / $8,047.50 / $8,047.50	Facility	50	$8,047.50	$8,047.50	$8,047.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.04 / $633.44 / $2,065.90	Professional		$392.04	$633.44	$2,065.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $689.81 / $1,113.81 / $1,528.76	Professional		$689.81	$1,113.81	$1,528.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $884.12 / $1,100.30 / $1,380.30	Professional		$884.12	$1,100.30	$1,380.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $631.07 / $1,005.64 / $1,361.90	Facility		$631.07	$1,005.64	$1,361.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $753.08 / $928.67 / $1,592.81	Professional		$753.08	$928.67	$1,592.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.21 / $999.70 / $1,161.10	Facility		$645.21	$999.70	$1,161.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $633.44 / $1,106.70 / $2,662.00	Facility		$633.44	$1,106.70	$2,662.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $858.01 / $1,172.50 / $1,562.79	Professional		$858.01	$1,172.50	$1,562.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,539.09 / $11,131.60 / $14,269.30	Facility		$8,539.09	$11,131.60	$14,269.30
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,808.64 / $16,697.40 / $21,403.95	Facility	50	$12,808.64	$16,697.40	$21,403.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $897.94 / $1,202.59 / $1,629.70	Professional		$897.94	$1,202.59	$1,629.70
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00
United Facility/Professional Professional Modifier Low / Median / High Price $850.65 / $1,309.68 / $1,829.91	Professional		$850.65	$1,309.68	$1,829.91