Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.73 / $523.36 / $7,920.26	Facility		$306.73	$523.36	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $282.39 / $323.42 / $392.52	Facility	54	$282.39	$323.42	$392.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $241.22 / $537.44	Professional		$163.97	$241.22	$537.44
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $122.99 / $195.61 / $473.49	Professional	54	$122.99	$195.61	$473.49
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 $215.77 / $383.49 / $581.10	Professional		$215.77	$383.49	$581.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $394.91 / $467.59 / $537.07	Professional		$394.91	$467.59	$537.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $221.56 / $344.52 / $486.20	Facility		$221.56	$344.52	$486.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $299.72 / $350.30 / $562.44	Professional		$299.72	$350.30	$562.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $227.53 / $368.11 / $425.45	Facility		$227.53	$368.11	$425.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $221.56 / $340.92 / $532.88	Facility		$221.56	$340.92	$532.88
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $386.73 / $386.73 / $386.73	Facility	54	$386.73	$386.73	$386.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $329.49 / $404.64 / $552.69	Professional		$329.49	$404.64	$552.69
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $296.20 / $324.89 / $445.82	Professional	54	$296.20	$324.89	$445.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $358.56 / $471.71 / $621.36	Professional		$358.56	$471.71	$621.36
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 $276.91 / $392.71 / $610.38	Professional		$276.91	$392.71	$610.38