Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.62 / $2,163.15 / $7,920.26	Facility		$339.62	$2,163.15	$7,920.26
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.92 / $170.40 / $505.37	Facility	53	$67.92	$170.40	$505.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.71 / $842.71 / $1,937.44	Facility		$842.71	$842.71	$1,937.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $291.14 / $427.74 / $771.09	Professional		$291.14	$427.74	$771.09
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $292.02 / $427.74 / $771.09	Professional	53	$292.02	$427.74	$771.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $233.93 / $447.29 / $848.58	Facility		$233.93	$447.29	$848.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.43 / $616.52 / $638.08	Facility		$281.43	$616.52	$638.08
Pacific Source Facility/Professional Facility Modifier 53 Low / Median / High Price $259.35 / $346.73 / $646.00	Facility	53	$259.35	$346.73	$646.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $233.93 / $501.04 / $987.62	Facility		$233.93	$501.04	$987.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,153.07 / $2,975.12 / $3,619.70	Facility		$2,153.07	$2,975.12	$3,619.70
Regence BlueShield Facility/Professional Facility Modifier 53 Low / Median / High Price $2,392.77 / $2,392.77 / $2,392.77	Facility	53	$2,392.77	$2,392.77	$2,392.77
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