Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.63 / $988.00 / $7,920.26	Facility		$247.63	$988.00	$7,920.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $185.73 / $212.91 / $273.74	Facility	54	$185.73	$212.91	$273.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $158.77 / $372.15	Professional		$113.84	$158.77	$372.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Facility		$78.00	$78.00	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $275.25 / $404.39	Professional		$157.05	$275.25	$404.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.11 / $314.81 / $366.33	Professional		$258.11	$314.81	$366.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $153.57 / $238.03 / $355.24	Facility		$153.57	$238.03	$355.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $207.64 / $244.12 / $370.97	Professional		$207.64	$244.12	$370.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $171.84 / $272.69 / $294.80	Facility		$171.84	$272.69	$294.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $148.41 / $237.60 / $369.84	Facility		$148.41	$237.60	$369.84
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $269.81 / $269.81 / $269.81	Facility	54	$269.81	$269.81	$269.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.48 / $279.81 / $380.57	Professional		$228.48	$279.81	$380.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $724.26 / $890.90	Facility		$564.70	$724.26	$890.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $233.71 / $317.52 / $408.37	Professional		$233.71	$317.52	$408.37
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 $189.45 / $286.93 / $454.26	Professional		$189.45	$286.93	$454.26