Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.78 / $2,403.00 / $8,485.40	Facility		$202.78	$2,403.00	$8,485.40
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.09 / $40.56 / $93.12	Facility	53	$34.09	$40.56	$93.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $194.78 / $499.51	Professional		$79.90	$194.78	$499.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.35 / $241.91 / $510.06	Professional		$129.35	$241.91	$510.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.15 / $213.91 / $452.28	Professional		$168.15	$213.91	$452.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $210.80 / $454.01	Facility		$104.71	$210.80	$454.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $139.83 / $293.55 / $480.36	Professional		$139.83	$293.55	$480.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.51 / $356.20 / $379.22	Facility		$169.51	$356.20	$379.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $230.47 / $480.33	Facility		$106.22	$230.47	$480.33
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.61 / $263.55 / $514.25	Professional		$160.61	$263.55	$514.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $156.86 / $286.89 / $504.24	Professional		$156.86	$286.89	$504.24
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.27 / $373.56 / $585.03	Professional		$204.27	$373.56	$585.03