Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.12 / $1,624.13 / $5,116.62	Facility		$218.12	$1,624.13	$5,116.62
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.90 / $48.93 / $129.27	Facility	53	$39.90	$48.93	$129.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $238.19 / $990.00	Professional		$94.12	$238.19	$990.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.99 / $291.06 / $706.26	Professional		$149.99	$291.06	$706.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.56 / $258.41 / $631.41	Professional		$205.56	$258.41	$631.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $288.01 / $593.45	Facility		$133.96	$288.01	$593.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $165.30 / $401.94 / $604.65	Professional		$165.30	$401.94	$604.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $193.63 / $464.31 / $519.91	Facility		$193.63	$464.31	$519.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $376.81 / $664.17	Facility		$133.96	$376.81	$664.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $185.25 / $337.73 / $683.38	Professional		$185.25	$337.73	$683.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,722.06 / $2,201.77 / $2,613.15	Facility		$1,722.06	$2,201.77	$2,613.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $189.04 / $316.13 / $733.37	Professional		$189.04	$316.13	$733.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $349.91 / $501.04 / $801.87	Professional		$349.91	$501.04	$801.87