Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $689.37 / $1,132.70 / $6,072.60	Facility		$689.37	$1,132.70	$6,072.60
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $698.05 / $882.51 / $1,910.41	Facility	54	$698.05	$882.51	$1,910.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $927.47 / $1,134.79 / $1,305.76	Professional		$927.47	$1,134.79	$1,305.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $626.75 / $890.65 / $1,266.50	Facility		$626.75	$890.65	$1,266.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $678.50 / $971.37 / $1,081.38	Facility		$678.50	$971.37	$1,081.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $626.75 / $893.55 / $1,418.44	Facility		$626.75	$893.55	$1,418.44
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,003.43 / $1,003.43 / $1,003.43	Facility	54	$1,003.43	$1,003.43	$1,003.43
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 $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00