Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $2,747.00 / $7,920.26	Facility		$988.00	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $721.21 / $805.85 / $986.18	Facility	54	$721.21	$805.85	$986.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $435.74 / $664.26 / $1,422.55	Professional		$435.74	$664.26	$1,422.55
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 $570.70 / $970.71 / $1,449.50	Professional		$570.70	$970.71	$1,449.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $947.03 / $1,139.32 / $1,296.97	Professional		$947.03	$1,139.32	$1,296.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $547.67 / $895.62 / $1,264.80	Facility		$547.67	$895.62	$1,264.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $786.42 / $883.06 / $1,371.14	Professional		$786.42	$883.06	$1,371.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $606.75 / $949.76 / $1,076.69	Facility		$606.75	$949.76	$1,076.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $895.62 / $1,416.17	Facility		$600.00	$895.62	$1,416.17
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,002.78 / $1,002.78 / $1,002.78	Facility	54	$1,002.78	$1,002.78	$1,002.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $881.05 / $1,031.47 / $1,424.41	Professional		$881.05	$1,031.47	$1,424.41
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 $899.18 / $1,182.90 / $1,546.23	Professional		$899.18	$1,182.90	$1,546.23
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 $721.28 / $1,049.99 / $1,650.34	Professional		$721.28	$1,049.99	$1,650.34