Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.19 / $464.93 / $5,709.00	Facility		$131.19	$464.93	$5,709.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $120.17 / $387.00	Professional		$57.69	$120.17	$387.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.15 / $202.51 / $648.00	Professional	50	$126.15	$202.51	$648.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $150.38 / $262.85	Professional		$90.53	$150.38	$262.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.10 / $151.72 / $240.86	Professional		$121.10	$151.72	$240.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.49 / $141.41 / $220.75	Facility		$83.49	$141.41	$220.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $156.60 / $240.98	Professional		$100.19	$156.60	$240.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.12 / $173.53 / $200.33	Facility		$104.12	$173.53	$200.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.49 / $141.41 / $256.57	Facility		$83.49	$141.41	$256.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $167.41 / $259.60	Professional		$112.14	$167.41	$259.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $737.82 / $929.08 / $1,109.00	Facility		$737.82	$929.08	$1,109.00
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,106.73 / $1,393.62 / $1,663.50	Facility	50	$1,106.73	$1,393.62	$1,663.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $113.92 / $183.89 / $271.73	Professional		$113.92	$183.89	$271.73
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 $132.09 / $184.92 / $289.01	Professional		$132.09	$184.92	$289.01