Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.85 / $200.92 / $509.60	Facility		$57.85	$200.92	$509.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $281.30 / $512.29 / $1,045.00	Facility	50	$281.30	$512.29	$1,045.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $83.84 / $155.27	Professional		$28.71	$83.84	$155.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.42 / $137.72 / $237.85	Professional	50	$33.42	$137.72	$237.85
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 $41.74 / $91.04 / $242.64	Professional		$41.74	$91.04	$242.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $83.40 / $217.65	Professional		$55.66	$83.40	$217.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $91.30 / $192.85	Facility		$30.60	$91.30	$192.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $96.39 / $198.39	Professional		$38.33	$96.39	$198.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.58 / $143.54 / $176.88	Facility		$53.58	$143.54	$176.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $128.71 / $229.11	Facility		$30.60	$128.71	$229.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $107.44 / $232.18	Professional		$50.40	$107.44	$232.18
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 $50.80 / $91.02 / $248.31	Professional		$50.80	$91.02	$248.31
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $1,078.00 / $6,216.00	Facility		$376.00	$1,078.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $167.64 / $273.92	Professional		$113.28	$167.64	$273.92