Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.39 / $3,213.00 / $6,629.40	Facility		$193.39	$3,213.00	$6,629.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $55.37 / $69.48 / $209.00	Facility	52	$55.37	$69.48	$209.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.15 / $27.79 / $83.60	Facility	53	$22.15	$27.79	$83.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.17 / $137.25 / $418.00	Professional		$58.17	$137.25	$418.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $256.17 / $256.17 / $1,937.44	Facility		$256.17	$256.17	$1,937.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $187.39 / $504.38	Professional		$86.78	$187.39	$504.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.91 / $176.59 / $464.06	Professional		$108.91	$176.59	$464.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $82.89 / $180.92 / $415.65	Facility		$82.89	$180.92	$415.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $96.79 / $211.20 / $450.43	Professional		$96.79	$211.20	$450.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.21 / $306.19 / $374.53	Facility		$115.21	$306.19	$374.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.15 / $194.54 / $480.54	Facility		$84.15	$194.54	$480.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.26 / $231.80 / $484.37	Professional		$106.26	$231.80	$484.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,153.07 / $2,839.75 / $3,421.41	Facility		$2,153.07	$2,839.75	$3,421.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.47 / $262.60 / $492.80	Professional		$107.47	$262.60	$492.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.00 / $2,261.00 / $4,911.00	Facility		$1,096.00	$2,261.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.89 / $327.05 / $580.16	Professional		$223.89	$327.05	$580.16