Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.98 / $446.20 / $6,096.00	Facility		$189.98	$446.20	$6,096.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $155.02 / $200.37 / $2,697.17	Facility	54	$155.02	$200.37	$2,697.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.31 / $140.41 / $377.54	Professional		$85.31	$140.41	$377.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.29 / $223.84 / $340.28	Professional		$142.29	$223.84	$340.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.20 / $244.31 / $300.69	Professional		$174.20	$244.31	$300.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $130.43 / $176.98 / $283.02	Facility		$130.43	$176.98	$283.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.09 / $204.95 / $343.74	Professional		$172.09	$204.95	$343.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.43 / $161.34 / $251.83	Facility		$111.43	$161.34	$251.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $124.28 / $185.83 / $322.64	Facility		$124.28	$185.83	$322.64
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $237.05 / $237.05 / $237.05	Facility	54	$237.05	$237.05	$237.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $178.07 / $233.39 / $324.02	Professional		$178.07	$233.39	$324.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $492.49 / $584.72 / $749.46	Facility		$492.49	$584.72	$749.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $193.12 / $252.32 / $361.79	Professional		$193.12	$252.32	$361.79
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $4,113.00 / $6,216.00	Facility		$376.00	$4,113.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.68 / $223.60 / $355.56	Professional		$161.68	$223.60	$355.56