Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $273.30 / $616.51 / $7,920.26	Facility		$273.30	$616.51	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $317.87 / $363.02 / $462.38	Facility	54	$317.87	$363.02	$462.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.53 / $281.08 / $659.50	Professional		$190.53	$281.08	$659.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Facility		$78.00	$78.00	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $444.18 / $673.11	Professional		$260.50	$444.18	$673.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $431.06 / $528.80 / $613.04	Professional		$431.06	$528.80	$613.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $257.00 / $398.66 / $574.79	Facility		$257.00	$398.66	$574.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $401.36 / $630.91	Professional		$348.00	$401.36	$630.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $285.42 / $435.50 / $499.82	Facility		$285.42	$435.50	$499.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $250.77 / $398.35 / $628.99	Facility		$250.77	$398.35	$628.99
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $461.89 / $461.89 / $461.89	Facility	54	$461.89	$461.89	$461.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $384.64 / $474.54 / $645.25	Professional		$384.64	$474.54	$645.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $395.47 / $537.42 / $694.52	Professional		$395.47	$537.42	$694.52
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
United Facility/Professional Professional Modifier Low / Median / High Price $325.30 / $479.49 / $738.69	Professional		$325.30	$479.49	$738.69