Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,288.25 / $5,011.87	Facility		$691.83	$1,288.25	$5,011.87
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,348.96 / $1,380.38 / $2,818.38	Facility	54	$1,348.96	$1,380.38	$2,818.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $1,202.26	Professional		$426.58	$512.86	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $851.14 / $1,318.26	Professional		$501.19	$851.14	$1,318.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,148.15 / $1,412.54	Professional		$891.25	$1,148.15	$1,412.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $758.58 / $1,318.26	Facility		$478.63	$758.58	$1,318.26
Moda Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,348.96 / $1,380.38 / $2,818.38	Facility	54	$1,348.96	$1,380.38	$2,818.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $1,348.96	Professional		$707.95	$891.25	$1,348.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $933.25 / $1,023.29	Facility		$676.08	$933.25	$1,023.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $724.44 / $1,096.48	Facility		$478.63	$724.44	$1,096.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $912.01 / $1,288.25	Professional		$79.43	$912.01	$1,288.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,011.87 / $6,025.60	Facility		$3,801.89	$5,011.87	$6,025.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $1,348.96	Professional		$776.25	$977.24	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $3,715.35 / $7,413.10	Facility		$1,096.48	$3,715.35	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $870.96 / $1,288.25	Professional		$588.84	$870.96	$1,288.25