Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.15 / $3,745.00 / $7,920.26	Facility		$184.15	$3,745.00	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.22 / $100.65 / $469.74	Facility	52	$84.22	$100.65	$469.74
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.69 / $40.26 / $187.89	Facility	53	$33.69	$40.26	$187.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.50 / $379.92 / $1,770.00	Professional		$78.50	$379.92	$1,770.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $359.78 / $1,041.91	Professional		$131.16	$359.78	$1,041.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $228.34 / $917.24	Professional		$155.41	$228.34	$917.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.12 / $349.08 / $1,049.75	Facility		$112.12	$349.08	$1,049.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $586.01 / $1,164.92	Professional		$131.29	$586.01	$1,164.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $160.19 / $676.02 / $806.48	Facility		$160.19	$676.02	$806.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.12 / $587.53 / $1,049.75	Facility		$112.12	$587.53	$1,049.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $158.08 / $491.17 / $1,108.07	Professional		$158.08	$491.17	$1,108.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,685.75 / $5,084.13 / $6,738.85	Facility		$3,685.75	$5,084.13	$6,738.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $284.58 / $1,097.21	Professional		$159.91	$284.58	$1,097.21
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 $580.38 / $796.60 / $1,220.52	Professional		$580.38	$796.60	$1,220.52