Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,684.68 / $8,728.00	Facility		$988.00	$4,684.68	$8,728.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $700.04 / $783.80 / $882.41	Facility	54	$700.04	$783.80	$882.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.07 / $633.62 / $1,511.05	Professional		$418.07	$633.62	$1,511.05
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 $537.84 / $896.66 / $1,360.16	Professional		$537.84	$896.66	$1,360.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $895.33 / $1,050.39 / $1,260.17	Professional		$895.33	$1,050.39	$1,260.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $610.97 / $840.24 / $1,121.15	Facility		$610.97	$840.24	$1,121.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $704.03 / $821.36 / $1,267.25	Professional		$704.03	$821.36	$1,267.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $639.05 / $883.43 / $964.13	Facility		$639.05	$883.43	$964.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $610.97 / $912.17 / $1,423.77	Facility		$610.97	$912.17	$1,423.77
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $898.07 / $898.07 / $898.07	Facility	54	$898.07	$898.07	$898.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $795.72 / $953.33 / $1,312.08	Professional		$795.72	$953.33	$1,312.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,820.30 / $4,901.89 / $6,016.60	Facility		$3,820.30	$4,901.89	$6,016.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $865.91 / $1,123.14 / $1,509.51	Professional		$865.91	$1,123.14	$1,509.51
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 $655.62 / $923.22 / $1,442.90	Professional		$655.62	$923.22	$1,442.90