Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.51 / $5,202.00 / $24,550.73	Facility		$707.51	$5,202.00	$24,550.73
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $621.22 / $621.22 / $689.76	Facility	52	$621.22	$621.22	$689.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $248.49 / $248.49 / $275.89	Facility	53	$248.49	$248.49	$275.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $530.37 / $727.54 / $3,016.44	Professional		$530.37	$727.54	$3,016.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $779.73 / $1,265.74 / $1,690.43	Professional		$779.73	$1,265.74	$1,690.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $895.52 / $1,266.49 / $1,441.74	Professional		$895.52	$1,266.49	$1,441.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $549.23 / $1,015.47 / $1,526.76	Facility		$549.23	$1,015.47	$1,526.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $918.52 / $1,213.56 / $1,825.91	Professional		$918.52	$1,213.56	$1,825.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $802.05 / $1,090.90 / $1,168.92	Facility		$802.05	$1,090.90	$1,168.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $549.23 / $1,107.43 / $1,526.76	Facility		$549.23	$1,107.43	$1,526.76
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $222.01 / $222.01 / $222.01	Facility	80	$222.01	$222.01	$222.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,025.24 / $1,349.57 / $1,767.48	Professional		$1,025.24	$1,349.57	$1,767.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,928.04 / $36,273.58 / $43,569.74	Facility		$27,928.04	$36,273.58	$43,569.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,086.52 / $1,388.42 / $1,828.91	Professional		$1,086.52	$1,388.42	$1,828.91
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $22,177.00 / $68,672.00	Facility		$3,028.00	$22,177.00	$68,672.00
United Facility/Professional Professional Modifier Low / Median / High Price $891.29 / $1,282.60 / $1,808.65	Professional		$891.29	$1,282.60	$1,808.65