Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.24 / $3,213.00 / $8,728.00	Facility		$191.24	$3,213.00	$8,728.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $86.81 / $107.28 / $296.66	Facility	52	$86.81	$107.28	$296.66
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.72 / $42.91 / $118.67	Facility	53	$34.72	$42.91	$118.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.06 / $216.03 / $461.30	Professional		$91.06	$216.03	$461.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $866.68 / $866.68 / $1,937.44	Facility		$866.68	$866.68	$1,937.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.65 / $257.64 / $711.83	Professional		$133.65	$257.64	$711.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.84 / $241.71 / $646.40	Professional		$165.84	$241.71	$646.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $131.25 / $287.27 / $606.27	Facility		$131.25	$287.27	$606.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $148.31 / $333.00 / $623.65	Professional		$148.31	$333.00	$623.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.98 / $444.04 / $529.29	Facility		$178.98	$444.04	$529.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $131.25 / $349.93 / $702.68	Facility		$131.25	$349.93	$702.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.32 / $324.95 / $683.05	Professional		$166.32	$324.95	$683.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,215.19 / $2,955.33 / $3,590.10	Facility		$2,215.19	$2,955.33	$3,590.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $167.68 / $403.75 / $724.20	Professional		$167.68	$403.75	$724.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,472.00 / $4,880.00 / $7,233.00	Facility		$1,472.00	$4,880.00	$7,233.00
United Facility/Professional Professional Modifier Low / Median / High Price $348.36 / $521.23 / $824.65	Professional		$348.36	$521.23	$824.65