Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,561.33 / $3,213.00 / $7,929.89	Facility		$1,561.33	$3,213.00	$7,929.89
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,223.58 / $1,373.70 / $1,533.06	Facility	54	$1,223.58	$1,373.70	$1,533.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $599.08 / $883.45 / $2,222.14	Professional		$599.08	$883.45	$2,222.14
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.44 / $190.41 / $395.70	Professional	55	$95.44	$190.41	$395.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $451.00 / $451.00 / $451.00	Facility		$451.00	$451.00	$451.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $793.80 / $1,276.76 / $2,176.67	Professional		$793.80	$1,276.76	$2,176.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $831.78 / $1,717.06 / $1,918.04	Professional		$831.78	$1,717.06	$1,918.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $831.78 / $1,289.26 / $1,996.52	Facility		$831.78	$1,289.26	$1,996.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,134.24 / $1,332.60 / $2,481.57	Professional		$1,134.24	$1,332.60	$2,481.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,005.97 / $1,419.73 / $1,644.18	Facility		$1,005.97	$1,419.73	$1,644.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $971.60 / $1,794.00 / $3,023.00	Facility		$971.60	$1,794.00	$3,023.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $640.44 / $1,555.90 / $1,555.90	Facility	54	$640.44	$1,555.90	$1,555.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,163.16 / $1,574.45 / $2,174.19	Professional		$1,163.16	$1,574.45	$2,174.19
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $288.73 / $306.38 / $382.15	Professional	55	$288.73	$306.38	$382.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,762.34 / $13,653.30 / $16,115.95	Facility		$10,762.34	$13,653.30	$16,115.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,501.29 / $1,609.33 / $2,220.82	Professional		$1,501.29	$1,609.33	$2,220.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $9,074.00 / $12,786.00	Facility		$1,981.00	$9,074.00	$12,786.00
United Facility/Professional Professional Modifier Low / Median / High Price $962.48 / $1,465.86 / $2,139.41	Professional		$962.48	$1,465.86	$2,139.41