Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $632.00 / $5,649.00 / $15,341.00	Facility		$632.00	$5,649.00	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $289.56 / $316.00 / $350.91	Facility	52	$289.56	$316.00	$350.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,059.63 / $2,059.63 / $7,234.03	Facility		$2,059.63	$2,059.63	$7,234.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $455.27 / $597.80 / $729.50	Professional		$455.27	$597.80	$729.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $294.52 / $468.56 / $936.50	Facility		$294.52	$468.56	$936.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.60 / $554.61 / $576.64	Facility		$398.60	$554.61	$576.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $314.52 / $679.29 / $982.80	Facility		$314.52	$679.29	$982.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,475.25 / $17,909.58 / $21,335.22	Facility		$13,475.25	$17,909.58	$21,335.22
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