Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $15,331.56 / $26,410.13	Facility		$2,747.00	$15,331.56	$26,410.13
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $650.67 / $716.16 / $801.39	Facility	52	$650.67	$716.16	$801.39
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $260.27 / $286.45 / $320.56	Facility	53	$260.27	$286.45	$320.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $632.69 / $981.50 / $2,900.99	Professional		$632.69	$981.50	$2,900.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,375.60 / $4,375.60 / $4,924.56	Facility		$4,375.60	$4,375.60	$4,924.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $664.13 / $1,286.27 / $1,834.07	Professional		$664.13	$1,286.27	$1,834.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,046.49 / $1,374.14 / $1,687.70	Professional		$1,046.49	$1,374.14	$1,687.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $742.96 / $1,257.18 / $2,052.98	Facility		$742.96	$1,257.18	$2,052.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,051.20 / $1,200.41 / $1,956.78	Professional		$1,051.20	$1,200.41	$1,956.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $922.00 / $1,252.23 / $1,334.64	Facility		$922.00	$1,252.23	$1,334.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $799.94 / $1,447.13 / $2,110.23	Facility		$799.94	$1,447.13	$2,110.23
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $253.88 / $253.88 / $253.88	Facility	80	$253.88	$253.88	$253.88
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $215.80 / $215.80 / $215.80	Facility	AS	$215.80	$215.80	$215.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,108.18 / $1,434.36 / $1,868.53	Professional		$1,108.18	$1,434.36	$1,868.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,624.30 / $18,659.50 / $21,600.03	Facility		$13,624.30	$18,659.50	$21,600.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,215.30 / $1,554.76 / $1,960.09	Professional		$1,215.30	$1,554.76	$1,960.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $16,309.00 / $22,988.00	Facility		$2,800.00	$16,309.00	$22,988.00
United Facility/Professional Professional Modifier Low / Median / High Price $969.01 / $1,343.30 / $2,062.40	Professional		$969.01	$1,343.30	$2,062.40