Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.72 / $1,228.13 / $7,920.26	Facility		$906.72	$1,228.13	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $680.04 / $764.06 / $965.64	Facility	54	$680.04	$764.06	$965.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.35 / $622.12 / $1,381.31	Professional		$413.35	$622.12	$1,381.31
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 $542.53 / $926.73 / $1,403.24	Professional		$542.53	$926.73	$1,403.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $907.23 / $1,102.59 / $1,271.19	Professional		$907.23	$1,102.59	$1,271.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $532.90 / $852.84 / $1,218.90	Facility		$532.90	$852.84	$1,218.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $745.88 / $844.33 / $1,328.12	Professional		$745.88	$844.33	$1,328.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $658.44 / $934.69 / $1,051.90	Facility		$658.44	$934.69	$1,051.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $866.54 / $1,369.89	Facility		$550.00	$866.54	$1,369.89
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $972.59 / $972.59 / $972.59	Facility	54	$972.59	$972.59	$972.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $824.34 / $999.09 / $1,372.98	Professional		$824.34	$999.09	$1,372.98
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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $850.58 / $1,142.44 / $1,471.75	Professional		$850.58	$1,142.44	$1,471.75
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 $702.65 / $975.11 / $1,546.41	Professional		$702.65	$975.11	$1,546.41