Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $1,995.26 / $3,890.45	Facility		$281.84	$1,995.26	$3,890.45
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,041.74 / $3,467.37 / $5,128.61	Facility	50	$2,041.74	$3,467.37	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $251.19 / $1,122.02	Professional		$100.00	$251.19	$1,122.02
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	22	$141.25	$141.25	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $354.81 / $1,412.54	Professional	50	$147.91	$354.81	$1,412.54
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	53	$36.31	$36.31	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $281.84 / $616.60	Professional		$144.54	$281.84	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $288.40 / $660.69	Professional		$190.55	$288.40	$660.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $323.59 / $1,737.80	Facility		$131.83	$323.59	$1,737.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,041.74 / $3,467.37 / $5,128.61	Facility	50	$2,041.74	$3,467.37	$5,128.61
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $354.81 / $602.56	Professional		$173.78	$354.81	$602.56
Moda Health Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	22	$141.25	$141.25	$190.55
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $354.81 / $1,348.96	Professional	50	$147.91	$354.81	$1,348.96
Moda Health Facility/Professional Professional Modifier 53 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	53	$138.04	$138.04	$138.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $446.68 / $501.19	Facility		$309.03	$446.68	$501.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $263.03 / $549.54	Facility		$123.03	$263.03	$549.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $288.40 / $616.60	Professional		$79.43	$288.40	$616.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,884.03 / $3,548.13	Facility		$2,290.87	$2,884.03	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $3,388.44 / $4,365.16 / $5,248.07	Facility	50	$3,388.44	$4,365.16	$5,248.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $346.74 / $616.60	Professional		$208.93	$346.74	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $3,311.31 / $7,413.10	Facility		$1,096.48	$3,311.31	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $316.23 / $575.44	Professional		$165.96	$316.23	$575.44