Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.34 / $4,684.68 / $8,728.00	Facility		$389.34	$4,684.68	$8,728.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $266.11 / $292.01 / $323.23	Facility	54	$266.11	$292.01	$323.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $314.91 / $379.22 / $442.53	Professional		$314.91	$379.22	$442.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $242.90 / $389.35 / $729.46	Facility		$242.90	$389.35	$729.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.46 / $341.27 / $386.24	Facility		$251.46	$341.27	$386.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $242.90 / $424.13 / $848.01	Facility		$242.90	$424.13	$848.01
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $342.40 / $342.40 / $342.40	Facility	54	$342.40	$342.40	$342.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
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