Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $449.55 / $5,380.00 / $8,875.64	Facility		$449.55	$5,380.00	$8,875.64
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $232.46 / $253.19 / $281.72	Facility	52	$232.46	$253.19	$281.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,487.79 / $1,487.79 / $2,310.00	Facility		$1,487.79	$1,487.79	$2,310.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $366.87 / $481.73 / $588.41	Professional		$366.87	$481.73	$588.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $271.97 / $490.01 / $752.52	Facility		$271.97	$490.01	$752.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $342.51 / $446.92 / $522.04	Facility		$342.51	$446.92	$522.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $289.04 / $569.38 / $804.35	Facility		$289.04	$569.38	$804.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,389.68 / $5,951.19 / $7,123.24	Facility		$4,389.68	$5,951.19	$7,123.24
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