Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $623.32 / $1,430.18 / $6,616.00	Facility		$623.32	$1,430.18	$6,616.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $467.49 / $542.01 / $624.04	Facility	54	$467.49	$542.01	$624.04
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $93.50 / $103.47 / $124.81	Facility	55	$93.50	$103.47	$124.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $370.04 / $836.89	Professional		$269.14	$370.04	$836.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $816.74 / $2,346.00	Professional	50	$436.08	$816.74	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $201.86 / $363.68 / $805.58	Professional	54	$201.86	$363.68	$805.58
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $40.36 / $72.73 / $161.12	Professional	55	$40.36	$72.73	$161.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $604.00 / $604.00 / $604.00	Facility		$604.00	$604.00	$604.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.07 / $525.92 / $876.92	Professional		$327.07	$525.92	$876.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $339.55 / $679.95 / $777.09	Professional		$339.55	$679.95	$777.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $327.14 / $523.59 / $857.11	Facility		$327.14	$523.59	$857.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $487.56 / $546.36 / $934.26	Professional		$487.56	$546.36	$934.26
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,269.83 / $1,269.83 / $1,269.83	Professional	50	$1,269.83	$1,269.83	$1,269.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $377.88 / $607.02 / $668.66	Facility		$377.88	$607.02	$668.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $347.19 / $604.00 / $1,125.72	Facility		$347.19	$604.00	$1,125.72
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $355.52 / $626.34 / $626.34	Facility	54	$355.52	$626.34	$626.34
Providence Facility/Professional Facility Modifier 55 Low / Median / High Price $76.18 / $156.59 / $156.59	Facility	55	$76.18	$156.59	$156.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.16 / $630.99 / $858.80	Professional		$487.16	$630.99	$858.80
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $488.80 / $503.84 / $663.17	Professional	54	$488.80	$503.84	$663.17
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $122.20 / $125.96 / $165.79	Professional	55	$122.20	$125.96	$165.79
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 $565.21 / $640.28 / $870.75	Professional		$565.21	$640.28	$870.75
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 $410.52 / $610.99 / $924.91	Professional		$410.52	$610.99	$924.91