Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $417.50 / $687.77 / $6,629.40	Facility		$417.50	$687.77	$6,629.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $293.89 / $376.36 / $427.52	Facility	52	$293.89	$376.36	$427.52
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $487.00 / $740.59 / $1,909.45	Facility	54	$487.00	$740.59	$1,909.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.24 / $374.50 / $815.88	Professional		$247.24	$374.50	$815.88
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 $344.51 / $597.75 / $928.04	Professional		$344.51	$597.75	$928.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $612.13 / $736.99 / $850.31	Professional		$612.13	$736.99	$850.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $356.46 / $553.30 / $765.85	Facility		$356.46	$553.30	$765.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $470.40 / $553.72 / $885.95	Professional		$470.40	$553.72	$885.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $384.58 / $578.10 / $683.72	Facility		$384.58	$578.10	$683.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $374.45 / $553.30 / $876.12	Facility		$374.45	$553.30	$876.12
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $632.12 / $632.12 / $632.12	Facility	54	$632.12	$632.12	$632.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $517.30 / $658.55 / $897.11	Professional		$517.30	$658.55	$897.11
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 $566.45 / $755.95 / $981.60	Professional		$566.45	$755.95	$981.60
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 $435.59 / $624.24 / $1,051.23	Professional		$435.59	$624.24	$1,051.23