Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $760.91 / $1,193.78 / $6,629.40	Facility		$760.91	$1,193.78	$6,629.40
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $735.64 / $940.55 / $2,840.13	Facility	54	$735.64	$940.55	$2,840.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.25 / $605.11 / $1,216.25	Professional		$399.25	$605.11	$1,216.25
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 $528.82 / $901.69 / $1,361.01	Professional		$528.82	$901.69	$1,361.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $878.29 / $1,076.74 / $1,237.72	Professional		$878.29	$1,076.74	$1,237.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $582.90 / $835.15 / $1,182.34	Facility		$582.90	$835.15	$1,182.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $719.20 / $839.51 / $1,348.46	Professional		$719.20	$839.51	$1,348.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $628.37 / $905.21 / $1,025.77	Facility		$628.37	$905.21	$1,025.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $567.90 / $847.32 / $1,330.05	Facility		$567.90	$847.32	$1,330.05
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $943.04 / $943.04 / $943.04	Facility	54	$943.04	$943.04	$943.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $800.15 / $972.87 / $1,333.83	Professional		$800.15	$972.87	$1,333.83
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 $825.99 / $1,115.78 / $1,429.79	Professional		$825.99	$1,115.78	$1,429.79
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 $671.51 / $979.29 / $1,588.38	Professional		$671.51	$979.29	$1,588.38