Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.06 / $3,764.96 / $8,728.00	Facility		$224.06	$3,764.96	$8,728.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.36 / $101.89 / $263.43	Facility	52	$84.36	$101.89	$263.43
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.75 / $40.75 / $105.37	Facility	53	$33.75	$40.75	$105.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $168.44 / $522.37	Professional		$86.88	$168.44	$522.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $246.74 / $576.74	Professional		$154.57	$246.74	$576.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.28 / $213.87 / $510.17	Professional		$156.28	$213.87	$510.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $312.77 / $576.29	Facility		$112.03	$312.77	$576.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $331.98 / $623.79	Professional		$140.94	$331.98	$623.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $233.16 / $407.36 / $444.88	Facility		$233.16	$407.36	$444.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $421.00 / $2,748.00	Facility		$112.03	$421.00	$2,748.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.19 / $274.95 / $593.13	Professional		$161.19	$274.95	$593.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,274.77 / $9,065.01 / $11,932.41	Facility		$4,274.77	$9,065.01	$11,932.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $160.56 / $285.75 / $607.35	Professional		$160.56	$285.75	$607.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.24 / $478.80 / $681.97	Professional		$318.24	$478.80	$681.97