Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $456.00 / $2,747.00 / $7,920.26	Facility		$456.00	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $335.32 / $382.21 / $443.05	Facility	54	$335.32	$382.21	$443.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.84 / $291.63 / $616.17	Professional		$184.84	$291.63	$616.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.84 / $445.43 / $652.29	Professional		$243.84	$445.43	$652.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $457.65 / $536.05 / $627.36	Professional		$457.65	$536.05	$627.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $247.71 / $392.16 / $544.85	Facility		$247.71	$392.16	$544.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $342.21 / $403.60 / $622.70	Professional		$342.21	$403.60	$622.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $287.39 / $414.73 / $470.34	Facility		$287.39	$414.73	$470.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $290.32 / $392.16 / $609.04	Facility		$290.32	$392.16	$609.04
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $429.77 / $429.77 / $429.77	Facility	54	$429.77	$429.77	$429.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $380.98 / $464.44 / $638.41	Professional		$380.98	$464.44	$638.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $412.67 / $553.25 / $735.40	Professional		$412.67	$553.25	$735.40
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 $306.12 / $442.41 / $714.83	Professional		$306.12	$442.41	$714.83