Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.80 / $1,530.00 / $7,769.96	Facility		$140.80	$1,530.00	$7,769.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $160.72 / $584.11	Professional		$87.28	$160.72	$584.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.24 / $200.19 / $317.18	Professional		$126.24	$200.19	$317.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.91 / $168.86 / $256.20	Professional		$114.91	$168.86	$256.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $94.07 / $164.66 / $340.81	Facility		$94.07	$164.66	$340.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.41 / $187.37 / $280.86	Professional		$123.41	$187.37	$280.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.22 / $220.45 / $303.95	Facility		$144.22	$220.45	$303.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.52 / $168.67 / $354.02	Facility		$93.52	$168.67	$354.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $36.79 / $36.79 / $36.79	Facility	AS	$36.79	$36.79	$36.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $140.16 / $213.10 / $307.24	Professional		$140.16	$213.10	$307.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $861.54 / $1,116.86 / $1,502.14	Facility		$861.54	$1,116.86	$1,502.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $142.43 / $218.17 / $350.37	Professional		$142.43	$218.17	$350.37
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.64 / $233.35 / $349.13	Professional		$164.64	$233.35	$349.13