Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.79 / $9,506.28 / $13,320.00	Facility		$1,202.79	$9,506.28	$13,320.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $132.55 / $160.00 / $476.87	Facility	53	$132.55	$160.00	$476.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.66 / $1,077.25 / $4,945.03	Professional		$324.66	$1,077.25	$4,945.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $573.51 / $964.70 / $2,629.57	Professional		$573.51	$964.70	$2,629.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.94 / $904.17 / $2,298.02	Professional		$616.94	$904.17	$2,298.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $444.79 / $982.06 / $2,936.75	Facility		$444.79	$982.06	$2,936.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $543.66 / $1,484.80 / $2,823.21	Professional		$543.66	$1,484.80	$2,823.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $677.38 / $1,822.13 / $2,194.90	Facility		$677.38	$1,822.13	$2,194.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $444.79 / $1,956.52 / $5,851.00	Facility		$444.79	$1,956.52	$5,851.00
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $334.72 / $334.72 / $334.72	Facility	AS	$334.72	$334.72	$334.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $627.84 / $1,297.38 / $2,950.28	Professional		$627.84	$1,297.38	$2,950.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,811.13 / $10,179.44 / $11,932.41	Facility		$7,811.13	$10,179.44	$11,932.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $635.10 / $1,793.75 / $2,810.29	Professional		$635.10	$1,793.75	$2,810.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $25,015.00	Facility		$2,155.00	$12,835.00	$25,015.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,591.72 / $2,412.71 / $3,155.51	Professional		$1,591.72	$2,412.71	$3,155.51