Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $305.52 / $560.59 / $7,920.26	Facility		$305.52	$560.59	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $308.92 / $347.95 / $420.44	Facility	54	$308.92	$347.95	$420.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $259.10 / $678.06	Professional		$175.61	$259.10	$678.06
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $134.19 / $208.16 / $508.54	Professional	54	$134.19	$208.16	$508.54
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 $242.55 / $417.07 / $616.38	Professional		$242.55	$417.07	$616.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $421.19 / $498.21 / $570.79	Professional		$421.19	$498.21	$570.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $235.60 / $378.72 / $531.20	Facility		$235.60	$378.72	$531.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $330.42 / $374.48 / $594.76	Professional		$330.42	$374.48	$594.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $267.17 / $411.34 / $453.59	Facility		$267.17	$411.34	$453.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $235.60 / $362.25 / $568.91	Facility		$235.60	$362.25	$568.91
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $418.20 / $418.20 / $418.20	Facility	54	$418.20	$418.20	$418.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $362.70 / $439.11 / $600.35	Professional		$362.70	$439.11	$600.35
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $325.52 / $353.98 / $494.76	Professional	54	$325.52	$353.98	$494.76
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 $383.16 / $504.07 / $663.99	Professional		$383.16	$504.07	$663.99
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $1,078.00 / $6,216.00	Facility		$376.00	$1,078.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $300.48 / $438.20 / $675.08	Professional		$300.48	$438.20	$675.08