Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $20,579.33 / $44,125.48	Facility		$2,747.00	$20,579.33	$44,125.48
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $18,759.00 / $18,759.00 / $31,338.00	Facility	50	$18,759.00	$18,759.00	$31,338.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,911.39 / $2,106.19 / $2,350.98	Facility	54	$1,911.39	$2,106.19	$2,350.98
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $17,594.30 / $17,594.30 / $17,594.30	Facility	AS	$17,594.30	$17,594.30	$17,594.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,204.74 / $1,937.18 / $26,979.05	Professional		$1,204.74	$1,937.18	$26,979.05
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $180.50 / $480.91 / $1,103.32	Professional	AS	$180.50	$480.91	$1,103.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,615.74 / $2,681.03 / $3,792.89	Professional		$1,615.74	$2,681.03	$3,792.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,358.71 / $2,772.88 / $3,314.60	Professional		$2,358.71	$2,772.88	$3,314.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,787.01 / $2,555.42 / $3,842.07	Facility		$1,787.01	$2,555.42	$3,842.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,492.50 / $3,395.60	Professional		$2,137.96	$2,492.50	$3,395.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,893.91 / $2,495.41 / $2,736.28	Facility		$1,893.91	$2,495.41	$2,736.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,787.01 / $2,612.14 / $3,388.77	Facility		$1,787.01	$2,612.14	$3,388.77
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $2,439.83 / $2,439.83 / $2,439.83	Facility	54	$2,439.83	$2,439.83	$2,439.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $487.97 / $487.97 / $487.97	Facility	80	$487.97	$487.97	$487.97
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $414.77 / $414.77 / $414.77	Facility	AS	$414.77	$414.77	$414.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,354.76 / $2,734.25 / $3,608.10	Professional		$2,354.76	$2,734.25	$3,608.10
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $325.41 / $370.52 / $526.89	Professional	AS	$325.41	$370.52	$526.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $31,482.28 / $42,249.68 / $50,743.40	Facility		$31,482.28	$42,249.68	$50,743.40
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $47,223.42 / $63,374.52 / $76,115.10	Facility	50	$47,223.42	$63,374.52	$76,115.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,358.64 / $3,010.39 / $4,045.99	Professional		$2,358.64	$3,010.39	$4,045.99
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $25,540.00 / $31,875.00	Facility		$3,340.00	$25,540.00	$31,875.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,952.01 / $2,659.48 / $4,042.08	Professional		$1,952.01	$2,659.48	$4,042.08