Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.96 / $128.24 / $527.88	Facility		$50.96	$128.24	$527.88
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $298.12 / $362.24 / $894.35	Facility	50	$298.12	$362.24	$894.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $49.12 / $136.13	Professional		$31.35	$49.12	$136.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.68 / $77.36 / $355.50	Professional	50	$73.68	$77.36	$355.50
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 $43.50 / $76.70 / $171.80	Professional		$43.50	$76.70	$171.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $66.73 / $155.12	Professional		$53.69	$66.73	$155.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $84.50 / $130.05	Facility		$36.54	$84.50	$130.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $82.56 / $143.66	Professional		$45.41	$82.56	$143.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.20 / $103.88 / $128.63	Facility		$63.20	$103.88	$128.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $85.05 / $143.47	Facility		$36.54	$85.05	$143.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.80 / $164.43	Professional		$50.12	$85.80	$164.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $376.96 / $498.08 / $590.98	Facility		$376.96	$498.08	$590.98
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $565.44 / $747.12 / $886.47	Facility	50	$565.44	$747.12	$886.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $83.30 / $175.22	Professional		$50.50	$83.30	$175.22
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 $82.80 / $117.00 / $186.04	Professional		$82.80	$117.00	$186.04