Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.66 / $5,649.00 / $15,341.00	Facility		$547.66	$5,649.00	$15,341.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $252.24 / $273.83 / $303.99	Facility	52	$252.24	$273.83	$303.99
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $100.90 / $109.53 / $121.59	Facility	53	$100.90	$109.53	$121.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,089.75 / $1,089.75 / $2,059.63	Facility		$1,089.75	$1,089.75	$2,059.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $394.67 / $518.23 / $631.02	Professional		$394.67	$518.23	$631.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $255.32 / $401.55 / $813.95	Facility		$255.32	$401.55	$813.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $346.26 / $480.78 / $501.16	Facility		$346.26	$480.78	$501.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $272.37 / $590.40 / $853.76	Facility		$272.37	$590.40	$853.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,830.49 / $3,730.83 / $4,417.60	Facility		$2,830.49	$3,730.83	$4,417.60
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