Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $781.61 / $2,747.00 / $7,920.26	Facility		$781.61	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $580.05 / $649.46 / $738.45	Facility	54	$580.05	$649.46	$738.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.41 / $532.09 / $1,040.80	Professional		$351.41	$532.09	$1,040.80
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 $453.92 / $751.95 / $1,138.96	Professional		$453.92	$751.95	$1,138.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $754.18 / $881.81 / $1,044.60	Professional		$754.18	$881.81	$1,044.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $424.31 / $707.04 / $942.65	Facility		$424.31	$707.04	$942.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $610.79 / $689.44 / $1,060.26	Professional		$610.79	$689.44	$1,060.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $499.50 / $726.39 / $806.68	Facility		$499.50	$726.39	$806.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $508.78 / $719.20 / $1,057.04	Facility		$508.78	$719.20	$1,057.04
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $752.25 / $752.25 / $752.25	Facility	54	$752.25	$752.25	$752.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $676.35 / $798.56 / $1,089.61	Professional		$676.35	$798.56	$1,089.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $933.97	Facility		$564.70	$724.26	$933.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $723.89 / $934.63 / $1,250.41	Professional		$723.89	$934.63	$1,250.41
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 $559.50 / $760.92 / $1,156.58	Professional		$559.50	$760.92	$1,156.58