Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $334.40 / $4,416.74 / $6,072.60	Facility		$334.40	$4,416.74	$6,072.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $82.22 / $82.22 / $150.51	Facility	52	$82.22	$82.22	$150.51
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $60.20 / $150.43 / $378.73	Facility	53	$60.20	$150.43	$378.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.09 / $293.80 / $744.81	Professional		$180.09	$293.80	$744.81
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $44.25 / $103.85 / $275.98	Professional	53	$44.25	$103.85	$275.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.71 / $842.71 / $2,310.00	Facility		$842.71	$842.71	$2,310.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $301.45	Professional		$301.45	$301.45	$301.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $344.59 / $496.35 / $825.74	Professional		$344.59	$496.35	$825.74
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $345.49 / $514.09 / $825.74	Professional	53	$345.49	$514.09	$825.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $238.86 / $466.38 / $840.58	Facility		$238.86	$466.38	$840.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $314.36 / $540.66 / $799.51	Professional		$314.36	$540.66	$799.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $333.98 / $662.38 / $739.54	Facility		$333.98	$662.38	$739.54
Pacific Source Facility/Professional Facility Modifier 53 Low / Median / High Price $278.05 / $375.46 / $701.76	Facility	53	$278.05	$375.46	$701.76
Pacific Source Facility/Professional Professional Modifier 53 Low / Median / High Price $216.80 / $373.80 / $687.99	Professional	53	$216.80	$373.80	$687.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $238.86 / $470.05 / $958.23	Facility		$238.86	$470.05	$958.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $342.90 / $539.13 / $885.51	Professional		$342.90	$539.13	$885.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,153.07 / $2,975.12 / $3,619.70	Facility		$2,153.07	$2,975.12	$3,619.70
Regence BlueShield Facility/Professional Facility Modifier 53 Low / Median / High Price $2,392.77 / $2,392.77 / $2,392.77	Facility	53	$2,392.77	$2,392.77	$2,392.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $308.94 / $551.79 / $917.10	Professional		$308.94	$551.79	$917.10
Regence BlueShield Facility/Professional Professional Modifier 53 Low / Median / High Price $154.47 / $275.62 / $451.69	Professional	53	$154.47	$275.62	$451.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.00 / $2,261.00 / $4,911.00	Facility		$1,096.00	$2,261.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $483.83 / $718.89 / $1,057.10	Professional		$483.83	$718.89	$1,057.10
United Facility/Professional Professional Modifier 53 Low / Median / High Price $204.61 / $204.61 / $204.61	Professional	53	$204.61	$204.61	$204.61