Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.66 / $2,480.13 / $6,629.40	Facility		$189.66	$2,480.13	$6,629.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.77 / $215.27 / $524.41	Professional		$82.77	$215.27	$524.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.07 / $145.07 / $145.07	Facility		$145.07	$145.07	$145.07
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $116.06 / $116.06 / $116.06	Facility	52	$116.06	$116.06	$116.06
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.01 / $29.01 / $29.01	Facility	53	$29.01	$29.01	$29.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.71 / $278.29 / $620.54	Professional		$132.71	$278.29	$620.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.16 / $226.86 / $552.03	Professional		$160.16	$226.86	$552.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $219.87 / $607.55	Facility		$89.01	$219.87	$607.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $135.04 / $268.44 / $581.22	Professional		$135.04	$268.44	$581.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $168.84 / $431.31 / $495.80	Facility		$168.84	$431.31	$495.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $99.86 / $239.46 / $607.55	Facility		$99.86	$239.46	$607.55
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $116.06 / $116.06 / $116.06	Facility	52	$116.06	$116.06	$116.06
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $29.01 / $29.01 / $29.01	Facility	53	$29.01	$29.01	$29.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.91 / $298.62 / $636.40	Professional		$161.91	$298.62	$636.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,757.70 / $2,201.77 / $2,738.85	Facility		$1,757.70	$2,201.77	$2,738.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $156.84 / $282.66 / $611.60	Professional		$156.84	$282.66	$611.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $3,758.00 / $7,480.00	Facility		$1,106.00	$3,758.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $377.40 / $532.79 / $739.42	Professional		$377.40	$532.79	$739.42