Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $471.42 / $1,239.61 / $7,920.26	Facility		$471.42	$1,239.61	$7,920.26
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,034.85 / $5,034.85 / $5,034.85	Facility	50	$5,034.85	$5,034.85	$5,034.85
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $353.57 / $438.71 / $557.97	Facility	54	$353.57	$438.71	$557.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.80 / $352.69 / $810.00	Professional		$243.80	$352.69	$810.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $442.29 / $2,704.50	Professional	50	$341.79	$442.29	$2,704.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $182.85 / $273.36 / $937.04	Professional	54	$182.85	$273.36	$937.04
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $36.57 / $54.67 / $187.41	Professional	55	$36.57	$54.67	$187.41
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 $282.83 / $457.50 / $746.83	Professional		$282.83	$457.50	$746.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.50 / $547.82 / $691.98	Professional		$302.50	$547.82	$691.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $280.22 / $472.80 / $767.40	Facility		$280.22	$472.80	$767.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $373.07 / $486.01 / $741.61	Professional		$373.07	$486.01	$741.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $547.57 / $598.30	Facility		$379.00	$547.57	$598.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $299.35 / $509.97 / $761.13	Facility		$299.35	$509.97	$761.13
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $271.12 / $563.38 / $563.38	Facility	54	$271.12	$563.38	$563.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $424.70 / $556.90 / $744.19	Professional		$424.70	$556.90	$744.19
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $441.48 / $455.06 / $598.40	Professional	54	$441.48	$455.06	$598.40
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $110.37 / $113.77 / $149.60	Professional	55	$110.37	$113.77	$149.60
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 $427.44 / $574.24 / $779.91	Professional		$427.44	$574.24	$779.91
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 $407.52 / $560.34 / $799.33	Professional		$407.52	$560.34	$799.33