Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $378.17 / $5,649.00 / $14,380.92	Facility		$378.17	$5,649.00	$14,380.92
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $717.98 / $717.98 / $1,956.50	Facility	50	$717.98	$717.98	$1,956.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $154.38 / $189.08 / $498.33	Facility	52	$154.38	$189.08	$498.33
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.76 / $75.63 / $199.33	Facility	53	$61.76	$75.63	$199.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.33 / $337.39 / $812.64	Professional		$144.33	$337.39	$812.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $270.37 / $301.05 / $1,028.00	Professional	50	$270.37	$301.05	$1,028.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.52 / $509.52 / $1,179.07	Professional		$266.52	$509.52	$1,179.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.57 / $429.22 / $923.25	Professional		$292.57	$429.22	$923.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $200.70 / $431.51 / $1,308.33	Facility		$200.70	$431.51	$1,308.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $247.65 / $598.29 / $1,177.80	Professional		$247.65	$598.29	$1,177.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.17 / $737.50 / $956.95	Facility		$302.17	$737.50	$956.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.16 / $759.53 / $2,327.00	Facility		$204.16	$759.53	$2,327.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $294.36 / $512.33 / $1,140.69	Professional		$294.36	$512.33	$1,140.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,508.06 / $10,952.22 / $13,050.49	Facility		$8,508.06	$10,952.22	$13,050.49
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $12,762.09 / $16,428.33 / $19,575.74	Facility	50	$12,762.09	$16,428.33	$19,575.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $294.57 / $741.11 / $1,141.74	Professional		$294.57	$741.11	$1,141.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.35 / $1,004.17 / $1,282.00	Professional		$686.35	$1,004.17	$1,282.00