Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.83 / $2,747.00 / $7,920.26	Facility		$243.83	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $179.78 / $204.21 / $234.01	Facility	54	$179.78	$204.21	$234.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $149.16 / $332.17	Professional		$104.62	$149.16	$332.17
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $82.16 / $122.16 / $299.74	Professional	54	$82.16	$122.16	$299.74
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 $137.19 / $236.50 / $353.93	Professional		$137.19	$236.50	$353.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.55 / $281.67 / $337.93	Professional		$237.55	$281.67	$337.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $163.54 / $225.76 / $327.66	Facility		$163.54	$225.76	$327.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $186.15 / $215.11 / $314.17	Professional		$186.15	$215.11	$314.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.50 / $232.49 / $251.92	Facility		$155.50	$232.49	$251.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $163.43 / $210.10 / $314.92	Facility		$163.43	$210.10	$314.92
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $228.70 / $228.70 / $228.70	Facility	54	$228.70	$228.70	$228.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.60 / $248.20 / $338.20	Professional		$209.60	$248.20	$338.20
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $179.42 / $198.24 / $270.56	Professional	54	$179.42	$198.24	$270.56
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 $224.49 / $292.69 / $389.02	Professional		$224.49	$292.69	$389.02
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 $170.03 / $252.96 / $374.20	Professional		$170.03	$252.96	$374.20