Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.50 / $7,074.00 / $13,320.00	Facility		$478.50	$7,074.00	$13,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $230.18 / $281.72 / $1,647.21	Facility	52	$230.18	$281.72	$1,647.21
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $92.07 / $112.69 / $658.88	Facility	53	$92.07	$112.69	$658.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.23 / $477.75 / $2,261.17	Professional		$266.23	$477.75	$2,261.17
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $53.25 / $242.96 / $846.21	Professional	53	$53.25	$242.96	$846.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.44 / $989.36 / $3,744.10	Professional		$392.44	$989.36	$3,744.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $433.07 / $1,184.28 / $3,124.52	Professional		$433.07	$1,184.28	$3,124.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $266.23 / $742.33 / $3,105.59	Facility		$266.23	$742.33	$3,105.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $384.54 / $678.60 / $3,485.97	Professional		$384.54	$678.60	$3,485.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $463.68 / $2,195.07 / $2,653.87	Facility		$463.68	$2,195.07	$2,653.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $340.83 / $985.15 / $4,556.81	Facility		$340.83	$985.15	$4,556.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $446.13 / $763.89 / $3,744.10	Professional		$446.13	$763.89	$3,744.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,041.14 / $9,224.37 / $11,703.59	Facility		$7,041.14	$9,224.37	$11,703.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.06 / $793.87 / $3,837.38	Professional		$446.06	$793.87	$3,837.38
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 $744.08 / $2,653.87 / $4,308.79	Professional		$744.08	$2,653.87	$4,308.79