Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.53 / $4,962.67 / $15,341.00	Facility		$77.53	$4,962.67	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.57 / $44.16 / $48.41	Facility	52	$40.57	$44.16	$48.41
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.23 / $17.66 / $19.36	Facility	53	$16.23	$17.66	$19.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $155.65 / $364.51	Facility		$155.65	$155.65	$364.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $83.88 / $101.75	Professional		$70.62	$83.88	$101.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.81 / $74.40 / $109.22	Facility		$42.81	$74.40	$109.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.17 / $77.08 / $80.23	Facility		$57.17	$77.08	$80.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.57 / $82.10 / $109.22	Facility		$45.57	$82.10	$109.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $951.44 / $1,116.86 / $1,502.14	Facility		$951.44	$1,116.86	$1,502.14
United Facility/Professional Facility Modifier Low / Median / High Price $49.65 / $3,290.00 / $6,216.00	Facility		$49.65	$3,290.00	$6,216.00