Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $991.47 / $4,637.05 / $8,728.00	Facility		$991.47	$4,637.05	$8,728.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $743.60 / $927.16 / $1,512.65	Facility	54	$743.60	$927.16	$1,512.65
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 $938.16 / $1,098.89 / $1,318.36	Professional		$938.16	$1,098.89	$1,318.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $657.87 / $905.76 / $1,207.84	Facility		$657.87	$905.76	$1,207.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $641.25 / $935.34 / $1,012.37	Facility		$641.25	$935.34	$1,012.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $657.87 / $989.27 / $2,450.00	Facility		$657.87	$989.27	$2,450.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $953.32 / $953.32 / $953.32	Facility	54	$953.32	$953.32	$953.32
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
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