Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.43 / $982.03 / $7,920.26	Facility		$453.43	$982.03	$7,920.26
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,963.50 / $1,963.50 / $3,491.74	Facility	50	$1,963.50	$1,963.50	$3,491.74
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $328.43 / $379.71 / $456.28	Facility	54	$328.43	$379.71	$456.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.49 / $330.07 / $660.92	Professional		$243.49	$330.07	$660.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $306.77 / $416.31 / $587.26	Professional	50	$306.77	$416.31	$587.26
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $164.54 / $288.29 / $873.93	Professional	54	$164.54	$288.29	$873.93
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $32.90 / $47.29 / $156.62	Professional	55	$32.90	$47.29	$156.62
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 $248.16 / $381.06 / $610.12	Professional		$248.16	$381.06	$610.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $247.56 / $469.80 / $570.50	Professional		$247.56	$469.80	$570.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $247.56 / $403.60 / $691.62	Facility		$247.56	$403.60	$691.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $342.20 / $443.47 / $646.13	Professional		$342.20	$443.47	$646.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $296.48 / $468.33 / $603.70	Facility		$296.48	$468.33	$603.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $261.64 / $442.14 / $691.49	Facility		$261.64	$442.14	$691.49
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $461.24 / $461.24	Facility	54	$238.23	$461.24	$461.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $365.33 / $463.19 / $617.10	Professional		$365.33	$463.19	$617.10
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $361.87 / $374.66 / $493.50	Professional	54	$361.87	$374.66	$493.50
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $90.47 / $93.67 / $123.38	Professional	55	$90.47	$93.67	$123.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,428.83 / $1,813.69 / $2,182.61	Facility		$1,428.83	$1,813.69	$2,182.61
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,143.25 / $2,720.54 / $3,273.92	Facility	50	$2,143.25	$2,720.54	$3,273.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $371.48 / $470.01 / $638.88	Professional		$371.48	$470.01	$638.88
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 $323.05 / $485.46 / $722.50	Professional		$323.05	$485.46	$722.50