Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $566.78 / $2,912.00 / $5,649.00	Facility		$566.78	$2,912.00	$5,649.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $106.64 / $128.84 / $331.18	Facility	52	$106.64	$128.84	$331.18
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $42.65 / $51.54 / $132.47	Facility	53	$42.65	$51.54	$132.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $288.86 / $756.39	Professional		$97.14	$288.86	$756.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $866.68 / $866.68 / $1,937.44	Facility		$866.68	$866.68	$1,937.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.02 / $306.81 / $785.35	Professional		$163.02	$306.81	$785.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.24 / $292.73 / $709.07	Professional		$199.24	$292.73	$709.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $157.87 / $308.57 / $762.64	Facility		$157.87	$308.57	$762.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.21 / $451.11 / $748.47	Professional		$173.21	$451.11	$748.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $221.99 / $560.12 / $607.69	Facility		$221.99	$560.12	$607.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $160.21 / $344.45 / $807.78	Facility		$160.21	$344.45	$807.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $201.24 / $373.25 / $783.02	Professional		$201.24	$373.25	$783.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,215.19 / $2,820.85 / $3,393.44	Facility		$2,215.19	$2,820.85	$3,393.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $201.99 / $527.83 / $818.15	Professional		$201.99	$527.83	$818.15
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
United Facility/Professional Professional Modifier Low / Median / High Price $436.32 / $599.92 / $923.69	Professional		$436.32	$599.92	$923.69