Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,580.10 / $7,920.26 / $20,400.00	Facility		$1,580.10	$7,920.26	$20,400.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,238.24 / $1,390.31 / $1,550.51	Facility	54	$1,238.24	$1,390.31	$1,550.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.03 / $902.85 / $1,796.56	Professional		$616.03	$902.85	$1,796.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $853.00 / $853.00 / $853.00	Facility		$853.00	$853.00	$853.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $787.73 / $1,293.40 / $2,201.44	Professional		$787.73	$1,293.40	$2,201.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $839.78 / $1,733.69 / $1,936.49	Professional		$839.78	$1,733.69	$1,936.49
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $839.78 / $1,301.66 / $2,076.12	Facility		$839.78	$1,301.66	$2,076.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,164.24 / $1,349.43 / $2,512.05	Professional		$1,164.24	$1,349.43	$2,512.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,030.88 / $1,441.84 / $1,662.94	Facility		$1,030.88	$1,441.84	$1,662.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $981.06 / $1,829.32 / $7,339.00	Facility		$981.06	$1,829.32	$7,339.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $647.74 / $1,574.52 / $1,574.52	Facility	54	$647.74	$1,574.52	$1,574.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,179.90 / $1,593.80 / $2,199.69	Professional		$1,179.90	$1,593.80	$2,199.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,698.81 / $7,379.02 / $8,723.76	Facility		$5,698.81	$7,379.02	$8,723.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,519.74 / $1,627.70 / $2,248.12	Professional		$1,519.74	$1,627.70	$2,248.12
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 $967.95 / $1,439.37 / $2,163.82	Professional		$967.95	$1,439.37	$2,163.82