Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $954.99 / $6,606.93	Facility		$380.19	$954.99	$6,606.93
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $154.88 / $269.15 / $549.54	Facility	53	$154.88	$269.15	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $1,949.84	Facility		$851.14	$851.14	$1,949.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $831.76	Professional		$269.15	$389.05	$831.76
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $269.15 / $389.05 / $831.76	Professional	53	$269.15	$389.05	$831.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $380.19 / $724.44	Facility		$169.82	$380.19	$724.44
Moda Health Facility/Professional Facility Modifier 53 Low / Median / High Price $144.54 / $269.15 / $549.54	Facility	53	$144.54	$269.15	$549.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $616.60 / $630.96	Facility		$501.19	$616.60	$630.96
Pacific Source Facility/Professional Facility Modifier 53 Low / Median / High Price $257.04 / $316.23 / $630.96	Facility	53	$257.04	$316.23	$630.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $346.74 / $707.95	Facility		$162.18	$346.74	$707.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,884.03 / $3,548.13	Facility		$2,137.96	$2,884.03	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier 53 Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility	53	$2,398.83	$2,398.83	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $4,570.88 / $7,244.36	Facility		$1,548.82	$4,570.88	$7,244.36