Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $689.87 / $3,663.89 / $15,050.19	Facility		$689.87	$3,663.89	$15,050.19
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,980.00 / $10,434.16 / $19,712.88	Facility	50	$6,980.00	$10,434.16	$19,712.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $285.26 / $1,200.83 / $2,955.22	Professional		$285.26	$1,200.83	$2,955.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $516.54 / $1,615.71 / $2,546.46	Professional	50	$516.54	$1,615.71	$2,546.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $558.72 / $558.72 / $558.72	Facility		$558.72	$558.72	$558.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.68 / $1,382.03 / $4,486.85	Professional		$462.68	$1,382.03	$4,486.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $644.48 / $879.26 / $4,120.91	Professional		$644.48	$879.26	$4,120.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $412.15 / $1,618.25 / $3,605.52	Facility		$412.15	$1,618.25	$3,605.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $551.05 / $1,042.94 / $4,324.00	Professional		$551.05	$1,042.94	$4,324.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $628.38 / $2,904.35 / $3,325.21	Facility		$628.38	$2,904.35	$3,325.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $412.63 / $1,756.55 / $4,233.87	Facility		$412.63	$1,756.55	$4,233.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $598.97 / $2,079.71 / $4,407.14	Professional		$598.97	$2,079.71	$4,407.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,954.82 / $18,400.34 / $20,571.93	Facility		$12,954.82	$18,400.34	$20,571.93
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $19,432.23 / $27,600.51 / $30,857.90	Facility	50	$19,432.23	$27,600.51	$30,857.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $591.66 / $2,039.67 / $4,341.92	Professional		$591.66	$2,039.67	$4,341.92
United Facility/Professional Facility Modifier Low / Median / High Price $7,612.00 / $18,628.00 / $26,255.00	Facility		$7,612.00	$18,628.00	$26,255.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,646.77 / $3,056.71 / $4,851.24	Professional		$1,646.77	$3,056.71	$4,851.24