Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.86 / $1,355.04 / $7,920.26	Facility		$792.86	$1,355.04	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $738.06 / $903.49 / $1,505.03	Facility	54	$738.06	$903.49	$1,505.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.06 / $567.92 / $1,347.85	Professional		$455.06	$567.92	$1,347.85
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 $586.29 / $996.09 / $1,484.90	Professional		$586.29	$996.09	$1,484.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $971.81 / $1,171.14 / $1,332.83	Professional		$971.81	$1,171.14	$1,332.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $925.17 / $1,311.55	Facility		$600.00	$925.17	$1,311.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $811.26 / $915.57 / $1,408.15	Professional		$811.26	$915.57	$1,408.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $704.72 / $1,013.53 / $1,108.84	Facility		$704.72	$1,013.53	$1,108.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $928.74 / $1,477.26	Facility		$600.00	$928.74	$1,477.26
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,031.70 / $1,031.70 / $1,031.70	Facility	54	$1,031.70	$1,031.70	$1,031.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $902.97 / $1,060.13 / $1,465.29	Professional		$902.97	$1,060.13	$1,465.29
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
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $919.47 / $1,211.29 / $1,583.99	Professional		$919.47	$1,211.29	$1,583.99
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
United Facility/Professional Professional Modifier Low / Median / High Price $721.69 / $1,048.56 / $1,662.89	Professional		$721.69	$1,048.56	$1,662.89