Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,806.92 / $21,695.07 / $49,612.33	Facility		$2,806.92	$21,695.07	$49,612.33
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $21,453.57 / $21,453.57 / $21,453.57	Facility	50	$21,453.57	$21,453.57	$21,453.57
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,913.52 / $2,108.23 / $2,354.31	Facility	54	$1,913.52	$2,108.23	$2,354.31
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $1,694.50 / $1,694.50 / $1,694.50	Facility	AS	$1,694.50	$1,694.50	$1,694.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,206.23 / $1,853.05 / $24,856.01	Professional		$1,206.23	$1,853.05	$24,856.01
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $164.05 / $354.37 / $911.74	Professional	AS	$164.05	$354.37	$911.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,617.37 / $2,636.20 / $3,798.79	Professional		$1,617.37	$2,636.20	$3,798.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,361.77 / $2,776.31 / $3,318.88	Professional		$2,361.77	$2,776.31	$3,318.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,789.04 / $2,450.23 / $3,440.07	Facility		$1,789.04	$2,450.23	$3,440.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,140.73 / $2,363.52 / $3,399.98	Professional		$2,140.73	$2,363.52	$3,399.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,894.88 / $2,498.48 / $2,627.07	Facility		$1,894.88	$2,498.48	$2,627.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,789.04 / $2,558.33 / $3,294.25	Facility		$1,789.04	$2,558.33	$3,294.25
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $2,442.41 / $2,442.41 / $2,442.41	Facility	54	$2,442.41	$2,442.41	$2,442.41
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,908.13 / $1,908.13 / $1,908.13	Facility	62	$1,908.13	$1,908.13	$1,908.13
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $488.48 / $488.48 / $488.48	Facility	80	$488.48	$488.48	$488.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $415.21 / $415.21 / $415.21	Facility	AS	$415.21	$415.21	$415.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,357.23 / $2,696.85 / $3,611.90	Professional		$2,357.23	$2,696.85	$3,611.90
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $327.05 / $370.71 / $501.53	Professional	AS	$327.05	$370.71	$501.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,710.28 / $44,586.59 / $50,743.40	Facility		$27,710.28	$44,586.59	$50,743.40
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $41,565.42 / $66,879.89 / $76,115.10	Facility	50	$41,565.42	$66,879.89	$76,115.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,361.10 / $3,015.07 / $4,052.29	Professional		$2,361.10	$3,015.07	$4,052.29
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $25,540.00 / $33,178.00	Facility		$3,340.00	$25,540.00	$33,178.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,921.28 / $2,705.49 / $4,046.31	Professional		$1,921.28	$2,705.49	$4,046.31