Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.89 / $2,747.00 / $7,920.26	Facility		$472.89	$2,747.00	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $236.45 / $257.73 / $286.27	Facility	52	$236.45	$257.73	$286.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,664.70 / $1,664.70 / $1,664.70	Facility		$1,664.70	$1,664.70	$1,664.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $372.63 / $489.30 / $594.36	Professional		$372.63	$489.30	$594.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $268.52 / $437.51 / $659.03	Facility		$268.52	$437.51	$659.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $341.09 / $453.93 / $479.05	Facility		$341.09	$453.93	$479.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $274.72 / $490.49 / $659.03	Facility		$274.72	$490.49	$659.03
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $91.48 / $91.48 / $91.48	Facility	80	$91.48	$91.48	$91.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $77.76 / $77.76 / $77.76	Facility	AS	$77.76	$77.76	$77.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,251.04 / $1,251.04 / $1,251.04	Facility		$1,251.04	$1,251.04	$1,251.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,345.00 / $7,664.00 / $31,303.00	Facility		$1,345.00	$7,664.00	$31,303.00