Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $947.32 / $2,747.00 / $7,920.26	Facility		$947.32	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $643.79 / $721.82 / $899.30	Facility	54	$643.79	$721.82	$899.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.94 / $585.55 / $1,275.18	Professional		$399.94	$585.55	$1,275.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.27 / $870.52 / $1,312.09	Professional		$506.27	$870.52	$1,312.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $858.22 / $1,030.44 / $1,184.67	Professional		$858.22	$1,030.44	$1,184.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $496.63 / $798.56 / $1,131.34	Facility		$496.63	$798.56	$1,131.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $702.96 / $799.80 / $1,243.67	Professional		$702.96	$799.80	$1,243.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $601.46 / $867.88 / $979.54	Facility		$601.46	$867.88	$979.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $558.33 / $811.51 / $1,273.63	Facility		$558.33	$811.51	$1,273.63
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $907.07 / $907.07 / $907.07	Facility	54	$907.07	$907.07	$907.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $778.12 / $933.05 / $1,282.49	Professional		$778.12	$933.05	$1,282.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,820.30 / $4,901.89 / $6,365.28	Facility		$3,820.30	$4,901.89	$6,365.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $803.84 / $1,066.92 / $1,390.97	Professional		$803.84	$1,066.92	$1,390.97
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 $670.66 / $967.25 / $1,450.46	Professional		$670.66	$967.25	$1,450.46