Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,884.74 / $11,652.00 / $23,856.49	Facility		$1,884.74	$11,652.00	$23,856.49
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,413.56 / $1,413.56 / $1,582.58	Facility	54	$1,413.56	$1,413.56	$1,582.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $1,038.00 / $1,835.92	Professional		$761.10	$1,038.00	$1,835.92
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.16 / $190.94 / $332.68	Professional	55	$95.16	$190.94	$332.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.00 / $691.00 / $691.00	Facility		$691.00	$691.00	$691.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.98 / $1,457.31 / $2,263.61	Professional		$915.98	$1,457.31	$2,263.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $856.78 / $1,789.15 / $1,987.95	Professional		$856.78	$1,789.15	$1,987.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $856.78 / $1,305.63 / $2,155.51	Facility		$856.78	$1,305.63	$2,155.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,352.97 / $1,574.36 / $2,689.53	Professional		$1,352.97	$1,574.36	$2,689.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,019.87 / $1,589.41 / $1,699.79	Facility		$1,019.87	$1,589.41	$1,699.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $888.19 / $1,640.10 / $2,153.83	Facility		$888.19	$1,640.10	$2,153.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $1,589.94 / $1,589.94	Facility	54	$662.09	$1,589.94	$1,589.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,462.73 / $1,658.25 / $2,280.76	Professional		$1,462.73	$1,658.25	$2,280.76
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $311.85 / $329.18 / $435.60	Professional	55	$311.85	$329.18	$435.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,594.94 / $14,524.38 / $20,699.53	Facility		$11,594.94	$14,524.38	$20,699.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,543.72 / $1,624.97 / $2,283.60	Professional		$1,543.72	$1,624.97	$2,283.60
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $16,268.00 / $24,231.00	Facility		$2,912.00	$16,268.00	$24,231.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,106.30 / $1,633.50 / $2,534.40	Professional		$1,106.30	$1,633.50	$2,534.40