Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.61 / $1,524.00 / $7,920.26	Facility		$144.61	$1,524.00	$7,920.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.79 / $117.57 / $362.80	Professional		$69.79	$117.57	$362.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.99 / $213.03 / $346.87	Professional		$123.99	$213.03	$346.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.61 / $206.49 / $300.35	Professional		$137.61	$206.49	$300.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.03 / $177.15 / $285.97	Facility		$108.03	$177.15	$285.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $137.16 / $203.00 / $272.67	Professional		$137.16	$203.00	$272.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $175.51 / $251.53	Facility		$129.47	$175.51	$251.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.80 / $186.68 / $330.37	Facility		$104.80	$186.68	$330.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $223.56 / $325.97	Professional		$150.29	$223.56	$325.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,719.37 / $2,217.60 / $2,633.84	Facility		$1,719.37	$2,217.60	$2,633.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.50 / $237.82 / $364.79	Professional		$162.50	$237.82	$364.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $232.05 / $369.00	Professional		$168.75	$232.05	$369.00