Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,991.12 / $14,614.14 / $23,856.49	Facility		$1,991.12	$14,614.14	$23,856.49
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,353.10 / $1,493.34 / $1,670.34	Facility	54	$1,353.10	$1,493.34	$1,670.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.41 / $942.12 / $2,200.88	Professional		$738.41	$942.12	$2,200.88
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $117.40 / $208.58 / $484.79	Professional	55	$117.40	$208.58	$484.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,119.00 / $1,119.00 / $1,119.00	Facility		$1,119.00	$1,119.00	$1,119.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $916.32 / $1,527.57 / $2,391.04	Professional		$916.32	$1,527.57	$2,391.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $905.01 / $1,886.05 / $2,095.61	Professional		$905.01	$1,886.05	$2,095.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $919.83 / $1,460.03 / $2,493.57	Facility		$919.83	$1,460.03	$2,493.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,396.20 / $1,512.53 / $2,696.07	Professional		$1,396.20	$1,512.53	$2,696.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,248.07 / $1,713.40 / $1,793.59	Facility		$1,248.07	$1,713.40	$1,793.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,101.52 / $2,099.04 / $9,060.00	Facility		$1,101.52	$2,099.04	$9,060.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $698.63 / $1,679.23 / $1,679.23	Facility	54	$698.63	$1,679.23	$1,679.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,389.42 / $1,723.80 / $2,383.17	Professional		$1,389.42	$1,723.80	$2,383.17
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $329.36 / $343.58 / $454.61	Professional	55	$329.36	$343.58	$454.61
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 $1,631.06 / $1,755.58 / $2,458.88	Professional		$1,631.06	$1,755.58	$2,458.88
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 $1,167.34 / $1,666.60 / $2,414.01	Professional		$1,167.34	$1,666.60	$2,414.01