Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.81 / $3,213.00 / $8,949.43	Facility		$426.81	$3,213.00	$8,949.43
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $122.38 / $149.37 / $323.16	Facility	52	$122.38	$149.37	$323.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.95 / $59.75 / $129.26	Facility	53	$48.95	$59.75	$129.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.77 / $272.35 / $646.32	Professional		$125.77	$272.35	$646.32
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 $188.35 / $336.69 / $772.86	Professional		$188.35	$336.69	$772.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.81 / $434.56 / $703.65	Professional		$229.81	$434.56	$703.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $184.73 / $397.17 / $746.95	Facility		$184.73	$397.17	$746.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $212.51 / $422.24 / $718.98	Professional		$212.51	$422.24	$718.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $278.00 / $524.34 / $598.30	Facility		$278.00	$524.34	$598.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $184.73 / $446.10 / $822.86	Facility		$184.73	$446.10	$822.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $232.20 / $385.42 / $752.55	Professional		$232.20	$385.42	$752.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,215.19 / $2,955.33 / $3,694.15	Facility		$2,215.19	$2,955.33	$3,694.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $233.06 / $486.32 / $782.60	Professional		$233.06	$486.32	$782.60
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 $414.96 / $584.35 / $897.17	Professional		$414.96	$584.35	$897.17