Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $778.13 / $3,819.00 / $8,083.00	Facility		$778.13	$3,819.00	$8,083.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $814.88 / $814.88 / $814.88	Facility	54	$814.88	$814.88	$814.88
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $162.97 / $162.97 / $162.97	Facility	55	$162.97	$162.97	$162.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $568.53 / $1,086.50 / $1,531.96	Professional		$568.53	$1,086.50	$1,531.96
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $567.92 / $814.88 / $1,198.23	Professional	54	$567.92	$814.88	$1,198.23
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $113.59 / $162.97 / $239.65	Professional	55	$113.59	$162.97	$239.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,819.00 / $3,819.00 / $3,819.00	Facility		$3,819.00	$3,819.00	$3,819.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.95 / $1,162.08 / $1,962.94	Professional		$659.95	$1,162.08	$1,962.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $436.14 / $674.74	Professional		$61.32	$436.14	$674.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,435.37 / $4,418.50 / $6,439.02	Facility		$3,435.37	$4,418.50	$6,439.02
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,153.06 / $6,627.75 / $9,658.53	Facility	50	$5,153.06	$6,627.75	$9,658.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $962.12 / $1,069.02 / $2,246.92	Professional		$962.12	$1,069.02	$2,246.92
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $3,819.00 / $6,959.00	Facility		$1,981.00	$3,819.00	$6,959.00
United Facility/Professional Professional Modifier Low / Median / High Price $688.59 / $964.08 / $1,223.95	Professional		$688.59	$964.08	$1,223.95