Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $633.60 / $2,059.17 / $7,920.26	Facility		$633.60	$2,059.17	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $687.27 / $1,351.50 / $1,711.90	Facility	54	$687.27	$1,351.50	$1,711.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $783.75 / $921.63 / $1,105.70	Professional		$783.75	$921.63	$1,105.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $505.60 / $745.04 / $978.35	Facility		$505.60	$745.04	$978.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $530.91 / $768.49 / $844.20	Facility		$530.91	$768.49	$844.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $531.04 / $797.15 / $2,450.00	Facility		$531.04	$797.15	$2,450.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $788.22 / $788.22 / $788.22	Facility	54	$788.22	$788.22	$788.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,820.30 / $4,901.89 / $6,016.60	Facility		$3,820.30	$4,901.89	$6,016.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00