Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.39 / $1,861.77 / $7,920.26	Facility		$292.39	$1,861.77	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $134.80 / $162.12 / $317.77	Facility	52	$134.80	$162.12	$317.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.95 / $202.99 / $677.21	Professional		$1.95	$202.99	$677.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.08 / $380.05 / $695.05	Professional		$233.08	$380.05	$695.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $249.56 / $340.44 / $625.12	Professional		$249.56	$340.44	$625.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.25 / $399.61 / $778.60	Facility		$199.25	$399.61	$778.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $216.67 / $417.60 / $700.28	Professional		$216.67	$417.60	$700.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $262.64 / $479.72 / $584.91	Facility		$262.64	$479.72	$584.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.25 / $484.09 / $2,327.00	Facility		$199.25	$484.09	$2,327.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $254.09 / $408.60 / $699.20	Professional		$254.09	$408.60	$699.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,032.32 / $5,176.14 / $6,353.74	Facility		$4,032.32	$5,176.14	$6,353.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $253.13 / $467.42 / $720.10	Professional		$253.13	$467.42	$720.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,241.93 / $7,385.00	Facility		$1,689.00	$5,241.93	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $386.64 / $615.29 / $808.55	Professional		$386.64	$615.29	$808.55