Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,546.09 / $7,920.26 / $20,400.00	Facility		$1,546.09	$7,920.26	$20,400.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,033.36 / $1,033.36 / $1,408.79	Facility	54	$1,033.36	$1,033.36	$1,408.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $668.79 / $1,031.32 / $2,293.88	Professional		$668.79	$1,031.32	$2,293.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $971.00 / $971.00 / $971.00	Facility		$971.00	$971.00	$971.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $968.45 / $1,446.50 / $2,131.04	Professional		$968.45	$1,446.50	$2,131.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $631.24 / $1,309.05 / $1,455.60	Professional		$631.24	$1,309.05	$1,455.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $674.84 / $1,293.82 / $2,657.40	Facility		$674.84	$1,293.82	$2,657.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $989.51 / $1,494.30 / $1,967.02	Professional		$989.51	$1,494.30	$1,967.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,018.97 / $1,314.67 / $1,881.36	Facility		$1,018.97	$1,314.67	$1,881.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $764.53 / $1,575.47 / $2,325.51	Facility		$764.53	$1,575.47	$2,325.51
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $484.63 / $1,412.64 / $1,412.64	Facility	54	$484.63	$1,412.64	$1,412.64
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $282.52 / $282.52 / $282.52	Facility	80	$282.52	$282.52	$282.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,175.04 / $1,534.90 / $2,131.04	Professional		$1,175.04	$1,534.90	$2,131.04
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $278.17 / $353.36 / $460.60	Professional	55	$278.17	$353.36	$460.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,678.59 / $12,937.69 / $16,102.64	Facility		$10,678.59	$12,937.69	$16,102.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,129.20 / $1,237.69 / $1,947.99	Professional		$1,129.20	$1,237.69	$1,947.99
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,248.16 / $1,686.52 / $2,382.53	Professional		$1,248.16	$1,686.52	$2,382.53