Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.38 / $739.55 / $6,629.40	Facility		$453.38	$739.55	$6,629.40
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $485.78 / $554.66 / $658.57	Facility	54	$485.78	$554.66	$658.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.69 / $369.02 / $950.78	Professional		$241.69	$369.02	$950.78
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $196.87 / $292.87 / $713.08	Professional	54	$196.87	$292.87	$713.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Facility		$78.00	$78.00	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.54 / $648.76 / $969.19	Professional		$349.54	$648.76	$969.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $670.26 / $798.35 / $917.03	Professional		$670.26	$798.35	$917.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $353.21 / $559.44 / $805.80	Facility		$353.21	$559.44	$805.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $462.06 / $587.52 / $940.60	Professional		$462.06	$587.52	$940.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $384.46 / $611.12 / $708.50	Facility		$384.46	$611.12	$708.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $353.21 / $547.48 / $896.71	Facility		$353.21	$547.48	$896.71
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $654.61 / $654.61 / $654.61	Facility	54	$654.61	$654.61	$654.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $538.01 / $686.69 / $934.83	Professional		$538.01	$686.69	$934.83
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $489.84 / $538.03 / $774.44	Professional	54	$489.84	$538.03	$774.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $933.97	Facility		$564.70	$724.26	$933.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $610.08 / $802.29 / $1,064.73	Professional		$610.08	$802.29	$1,064.73
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 $463.98 / $680.91 / $1,025.55	Professional		$463.98	$680.91	$1,025.55