Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,298.25 / $4,962.67 / $15,341.00	Facility		$1,298.25	$4,962.67	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $583.45 / $649.13 / $725.95	Facility	52	$583.45	$649.13	$725.95
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $875.18 / $973.69 / $1,088.92	Facility	54	$875.18	$973.69	$1,088.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.00 / $736.00 / $736.00	Facility		$736.00	$736.00	$736.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,097.14 / $1,285.10 / $1,541.76	Professional		$1,097.14	$1,285.10	$1,541.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $773.50 / $1,065.78 / $1,414.40	Facility		$773.50	$1,065.78	$1,414.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $808.15 / $1,108.18 / $1,191.93	Facility		$808.15	$1,108.18	$1,191.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $783.49 / $1,160.45 / $2,919.00	Facility		$783.49	$1,160.45	$2,919.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,121.63 / $1,121.63 / $1,121.63	Facility	54	$1,121.63	$1,121.63	$1,121.63
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
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00