Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.23 / $829.02 / $7,920.26	Facility		$556.23	$829.02	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $506.88 / $653.16 / $2,509.44	Facility	54	$506.88	$653.16	$2,509.44
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 $689.91 / $830.80 / $953.93	Professional		$689.91	$830.80	$953.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $399.90 / $637.49 / $886.55	Facility		$399.90	$637.49	$886.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $439.45 / $672.10 / $789.26	Facility		$439.45	$672.10	$789.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $436.84 / $638.96 / $997.11	Facility		$436.84	$638.96	$997.11
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $723.98 / $723.98 / $723.98	Facility	54	$723.98	$723.98	$723.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
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