Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.62 / $3,213.00 / $8,728.00	Facility		$253.62	$3,213.00	$8,728.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $113.68 / $142.25 / $214.23	Facility	52	$113.68	$142.25	$214.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.79 / $181.92 / $570.62	Professional		$121.79	$181.92	$570.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.94 / $303.02 / $465.09	Professional		$175.94	$303.02	$465.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.29 / $299.74 / $414.97	Professional		$221.29	$299.74	$414.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.76 / $284.38 / $449.65	Facility		$169.76	$284.38	$449.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $191.37 / $281.01 / $508.86	Professional		$191.37	$281.01	$508.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $202.20 / $315.33 / $348.40	Facility		$202.20	$315.33	$348.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.76 / $357.28 / $1,738.00	Facility		$169.76	$357.28	$1,738.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $321.10 / $475.17	Professional		$217.46	$321.10	$475.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,245.03 / $1,561.00 / $2,179.07	Facility		$1,245.03	$1,561.00	$2,179.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $221.41 / $324.05 / $490.80	Professional		$221.41	$324.05	$490.80
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 $248.88 / $379.59 / $551.11	Professional		$248.88	$379.59	$551.11