Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.56 / $1,084.92 / $6,629.40	Facility		$851.56	$1,084.92	$6,629.40
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $638.66 / $813.69 / $1,300.61	Facility	54	$638.66	$813.69	$1,300.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.50 / $496.35 / $1,146.83	Professional		$393.50	$496.35	$1,146.83
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 $509.30 / $873.29 / $1,313.14	Professional		$509.30	$873.29	$1,313.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $856.42 / $1,037.04 / $1,193.50	Professional		$856.42	$1,037.04	$1,193.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $603.85 / $809.38 / $1,140.70	Facility		$603.85	$809.38	$1,140.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $700.64 / $800.80 / $1,250.65	Professional		$700.64	$800.80	$1,250.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $607.04 / $879.42 / $988.92	Facility		$607.04	$879.42	$988.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $594.24 / $817.65 / $1,294.91	Facility		$594.24	$817.65	$1,294.91
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $910.28 / $910.28 / $910.28	Facility	54	$910.28	$910.28	$910.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $779.78 / $940.82 / $1,291.88	Professional		$779.78	$940.82	$1,291.88
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 $803.84 / $1,075.80 / $1,392.02	Professional		$803.84	$1,075.80	$1,392.02
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $660.52 / $950.34 / $1,505.30	Professional		$660.52	$950.34	$1,505.30