Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $290.54 / $433.28 / $7,920.26	Facility		$290.54	$433.28	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $281.77 / $322.14 / $370.58	Facility	54	$281.77	$322.14	$370.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $216.80 / $494.11	Professional		$153.71	$216.80	$494.11
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 $202.95 / $365.99 / $543.24	Professional		$202.95	$365.99	$543.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.48 / $449.17 / $532.41	Professional		$383.48	$449.17	$532.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $205.07 / $325.12 / $451.35	Facility		$205.07	$325.12	$451.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $283.80 / $340.38 / $532.74	Professional		$283.80	$340.38	$532.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $231.06 / $349.07 / $397.31	Facility		$231.06	$349.07	$397.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $205.07 / $321.72 / $498.56	Facility		$205.07	$321.72	$498.56
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $361.67 / $361.67 / $361.67	Facility	54	$361.67	$361.67	$361.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $315.57 / $386.76 / $534.85	Professional		$315.57	$386.76	$534.85
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 $344.53 / $462.84 / $619.23	Professional		$344.53	$462.84	$619.23
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 $258.67 / $372.41 / $573.72	Professional		$258.67	$372.41	$573.72