Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,770.05 / $18,977.96 / $53,220.04	Facility		$1,770.05	$18,977.96	$53,220.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $406.32 / $406.32 / $445.01	Facility	53	$406.32	$406.32	$445.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $919.70 / $1,333.58 / $4,561.00	Professional		$919.70	$1,333.58	$4,561.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,482.29 / $2,084.42 / $2,987.07	Professional		$1,482.29	$2,084.42	$2,987.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,444.47 / $2,048.51 / $2,331.96	Professional		$1,444.47	$2,048.51	$2,331.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $888.36 / $1,817.97 / $3,000.56	Facility		$888.36	$1,817.97	$3,000.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.47 / $2,107.13 / $2,941.01	Professional		$1,479.47	$2,107.13	$2,941.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,492.03 / $1,855.23 / $2,205.33	Facility		$1,492.03	$1,855.23	$2,205.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $888.36 / $2,403.54 / $3,000.56	Facility		$888.36	$2,403.54	$3,000.56
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $422.19 / $422.19 / $422.19	Facility	80	$422.19	$422.19	$422.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,792.64 / $2,319.04 / $3,176.21	Professional		$1,792.64	$2,319.04	$3,176.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57,598.85 / $77,123.97 / $88,910.09	Facility		$57,598.85	$77,123.97	$88,910.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,773.53 / $2,266.29 / $2,985.31	Professional		$1,773.53	$2,266.29	$2,985.31
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $50,817.00 / $61,876.00	Facility		$3,960.00	$50,817.00	$61,876.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,696.24 / $2,319.04 / $3,099.30	Professional		$1,696.24	$2,319.04	$3,099.30