Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.12 / $3,213.00 / $6,629.40	Facility		$293.12	$3,213.00	$6,629.40
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.63 / $73.55 / $420.38	Facility	53	$61.63	$73.55	$420.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $367.74 / $2,101.89	Professional		$148.71	$367.74	$2,101.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.19 / $758.27 / $2,476.15	Professional		$264.19	$758.27	$2,476.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $282.70 / $779.51 / $2,053.44	Professional		$282.70	$779.51	$2,053.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $226.81 / $779.51 / $2,478.00	Facility		$226.81	$779.51	$2,478.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $238.57 / $1,188.74 / $2,599.37	Professional		$238.57	$1,188.74	$2,599.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $291.39 / $1,501.10 / $1,803.36	Facility		$291.39	$1,501.10	$1,803.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $226.81 / $1,486.95 / $2,478.00	Facility		$226.81	$1,486.95	$2,478.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $293.04 / $1,092.67 / $2,464.11	Professional		$293.04	$1,092.67	$2,464.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,965.77 / $5,124.10 / $6,421.06	Facility		$3,965.77	$5,124.10	$6,421.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $289.39 / $515.03 / $2,456.87	Professional		$289.39	$515.03	$2,456.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,470.56 / $2,108.83 / $2,758.71	Professional		$1,470.56	$2,108.83	$2,758.71