Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $972.30 / $2,747.00 / $7,920.26	Facility		$972.30	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $715.89 / $801.66 / $920.95	Facility	54	$715.89	$801.66	$920.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.18 / $647.79 / $1,546.95	Professional		$428.18	$647.79	$1,546.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $548.11 / $933.21 / $1,393.09	Professional		$548.11	$933.21	$1,393.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $931.14 / $1,093.74 / $1,288.08	Professional		$931.14	$1,093.74	$1,288.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $496.13 / $849.60 / $1,156.00	Facility		$496.13	$849.60	$1,156.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $748.13 / $853.63 / $1,294.33	Professional		$748.13	$853.63	$1,294.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $595.36 / $903.16 / $1,005.67	Facility		$595.36	$903.16	$1,005.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $849.60 / $1,299.54	Facility		$550.00	$849.60	$1,299.54
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $935.98 / $935.98 / $935.98	Facility	54	$935.98	$935.98	$935.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $827.81 / $990.00 / $1,352.66	Professional		$827.81	$990.00	$1,352.66
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 $886.87 / $1,160.86 / $1,545.18	Professional		$886.87	$1,160.86	$1,545.18
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 $666.71 / $958.40 / $1,534.32	Professional		$666.71	$958.40	$1,534.32