Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $701.90 / $5,649.00 / $15,341.00	Facility		$701.90	$5,649.00	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $322.62 / $350.95 / $390.84	Facility	52	$322.62	$350.95	$390.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $129.05 / $140.38 / $156.34	Facility	53	$129.05	$140.38	$156.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,310.00 / $2,310.00 / $3,229.54	Facility		$2,310.00	$2,310.00	$3,229.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $507.21 / $666.01 / $812.66	Professional		$507.21	$666.01	$812.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $349.89 / $624.45 / $953.37	Facility		$349.89	$624.45	$953.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $459.31 / $617.88 / $659.28	Facility		$459.31	$617.88	$659.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $400.90 / $737.08 / $1,094.56	Facility		$400.90	$737.08	$1,094.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,453.20 / $11,142.10 / $14,336.76	Facility		$8,453.20	$11,142.10	$14,336.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,533.00 / $8,090.00 / $12,786.00	Facility		$1,533.00	$8,090.00	$12,786.00