Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.04 / $4,941.47 / $13,320.00	Facility		$386.04	$4,941.47	$13,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $1,808.85 / $3,799.21	Professional		$158.83	$1,808.85	$3,799.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.09 / $1,552.85 / $2,885.34	Professional	50	$126.09	$1,552.85	$2,885.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.50 / $1,474.88 / $4,847.08	Professional		$268.50	$1,474.88	$4,847.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $299.05 / $1,497.49 / $3,973.06	Professional		$299.05	$1,497.49	$3,973.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $231.89 / $1,665.56 / $5,679.02	Facility		$231.89	$1,665.56	$5,679.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $253.98 / $2,511.14 / $4,841.88	Professional		$253.98	$2,511.14	$4,841.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $314.23 / $3,101.79 / $3,862.69	Facility		$314.23	$3,101.79	$3,862.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $231.89 / $2,982.88 / $5,183.30	Facility		$231.89	$2,982.88	$5,183.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.51 / $2,155.51 / $4,823.52	Professional		$302.51	$2,155.51	$4,823.52
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $524.72 / $647.09 / $958.35	Professional	80	$524.72	$647.09	$958.35
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $446.01 / $550.02 / $814.60	Professional	AS	$446.01	$550.02	$814.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15,198.09 / $20,033.77 / $25,621.76	Facility		$15,198.09	$20,033.77	$25,621.76
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $22,797.14 / $30,050.66 / $38,432.64	Facility	50	$22,797.14	$30,050.66	$38,432.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $303.63 / $540.38 / $4,812.35	Professional		$303.63	$540.38	$4,812.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,784.09 / $4,202.64 / $5,403.54	Professional		$2,784.09	$4,202.64	$5,403.54