Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $778.52 / $1,326.84 / $7,920.26	Facility		$778.52	$1,326.84	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $747.99 / $836.50 / $995.13	Facility	54	$747.99	$836.50	$995.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $449.59 / $681.18 / $1,429.46	Professional		$449.59	$681.18	$1,429.46
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 $586.51 / $1,001.33 / $1,464.25	Professional		$586.51	$1,001.33	$1,464.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $991.17 / $1,185.01 / $1,354.95	Professional		$991.17	$1,185.01	$1,354.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $555.66 / $922.99 / $1,281.80	Facility		$555.66	$922.99	$1,281.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $803.25 / $900.72 / $1,376.32	Professional		$803.25	$900.72	$1,376.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.57 / $971.10 / $1,085.40	Facility		$616.57	$971.10	$1,085.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $924.42 / $1,436.53	Facility		$600.00	$924.42	$1,436.53
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,011.78 / $1,011.78 / $1,011.78	Facility	54	$1,011.78	$1,011.78	$1,011.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $892.08 / $1,062.02 / $1,447.10	Professional		$892.08	$1,062.02	$1,447.10
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 $931.77 / $1,220.52 / $1,608.12	Professional		$931.77	$1,220.52	$1,608.12
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 $761.95 / $1,056.30 / $1,627.30	Professional		$761.95	$1,056.30	$1,627.30