Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.37 / $3,995.73 / $8,636.46	Facility		$301.37	$3,995.73	$8,636.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $138.19 / $168.63 / $423.45	Facility	52	$138.19	$168.63	$423.45
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.28 / $67.45 / $169.38	Facility	53	$55.28	$67.45	$169.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $256.16 / $868.00	Professional		$79.45	$256.16	$868.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $866.68 / $866.68 / $2,310.00	Facility		$866.68	$866.68	$2,310.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.76 / $401.35 / $1,011.98	Professional		$211.76	$401.35	$1,011.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.48 / $562.61 / $913.71	Professional		$258.48	$562.61	$913.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.53 / $448.34 / $950.59	Facility		$208.53	$448.34	$950.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $236.64 / $535.66 / $907.06	Professional		$236.64	$535.66	$907.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $292.98 / $671.37 / $758.44	Facility		$292.98	$671.37	$758.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.53 / $513.48 / $1,030.90	Facility		$208.53	$513.48	$1,030.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $261.87 / $483.42 / $985.45	Professional		$261.87	$483.42	$985.45
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 $262.83 / $630.13 / $1,024.80	Professional		$262.83	$630.13	$1,024.80
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 $531.50 / $768.73 / $1,174.82	Professional		$531.50	$768.73	$1,174.82