Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $244.22 / $1,986.69 / $4,704.00	Facility		$244.22	$1,986.69	$4,704.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,022.45 / $3,815.15 / $5,090.62	Facility	50	$2,022.45	$3,815.15	$5,090.62
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.90 / $54.98 / $123.27	Facility	53	$44.90	$54.98	$123.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.10 / $270.45 / $1,215.41	Professional		$95.10	$270.45	$1,215.41
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.93 / $377.56 / $1,402.63	Professional	50	$148.93	$377.56	$1,402.63
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.85 / $47.56 / $118.09	Professional	53	$20.85	$47.56	$118.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.88 / $305.05 / $663.39	Professional		$170.88	$305.05	$663.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $231.11 / $291.72 / $602.96	Professional		$231.11	$291.72	$602.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $151.40 / $325.64 / $558.37	Facility		$151.40	$325.64	$558.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $186.18 / $357.86 / $567.67	Professional		$186.18	$357.86	$567.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $215.07 / $413.39 / $495.80	Facility		$215.07	$413.39	$495.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.40 / $351.16 / $720.44	Facility		$151.40	$351.16	$720.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $206.57 / $341.72 / $637.90	Professional		$206.57	$341.72	$637.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,265.38 / $2,900.22 / $3,412.14	Facility		$2,265.38	$2,900.22	$3,412.14
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $3,398.07 / $4,350.33 / $5,118.21	Facility	50	$3,398.07	$4,350.33	$5,118.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.49 / $348.52 / $686.82	Professional		$208.49	$348.52	$686.82
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 $347.32 / $471.09 / $775.74	Professional		$347.32	$471.09	$775.74