Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $785.49 / $1,818.71 / $7,920.26	Facility		$785.49	$1,818.71	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $569.04 / $858.80 / $1,545.68	Facility	54	$569.04	$858.80	$1,545.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $745.90 / $875.24 / $1,050.03	Professional		$745.90	$875.24	$1,050.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $487.20 / $685.93 / $898.45	Facility		$487.20	$685.93	$898.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $470.32 / $702.83 / $804.00	Facility		$470.32	$702.83	$804.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $490.04 / $729.20 / $1,156.33	Facility		$490.04	$729.20	$1,156.33
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $736.19 / $736.19 / $736.19	Facility	54	$736.19	$736.19	$736.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
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