Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $483.68 / $2,824.50 / $15,341.00	Facility		$483.68	$2,824.50	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $198.91 / $217.31 / $241.84	Facility	52	$198.91	$217.31	$241.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $79.56 / $86.92 / $96.74	Facility	53	$79.56	$86.92	$96.74
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 $314.49 / $412.96 / $504.14	Professional		$314.49	$412.96	$504.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $233.02 / $409.82 / $643.15	Facility		$233.02	$409.82	$643.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $284.89 / $383.11 / $440.16	Facility		$284.89	$383.11	$440.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $260.70 / $486.38 / $694.20	Facility		$260.70	$486.38	$694.20
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $294.60 / $294.60 / $294.60	Facility	62	$294.60	$294.60	$294.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $75.42 / $75.42 / $75.42	Facility	80	$75.42	$75.42	$75.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $64.09 / $64.09 / $64.09	Facility	AS	$64.09	$64.09	$64.09
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