Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.22 / $4,704.00 / $8,728.00	Facility		$173.22	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $115.59 / $411.65	Professional		$83.86	$115.59	$411.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.85 / $175.85 / $255.80	Professional		$113.85	$175.85	$255.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.84 / $175.57 / $197.68	Professional		$124.84	$175.57	$197.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $115.59 / $185.92 / $248.52	Facility		$115.59	$185.92	$248.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $124.36 / $161.44 / $247.21	Professional		$124.36	$161.44	$247.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.01 / $152.08 / $172.92	Facility		$109.01	$152.08	$172.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.59 / $197.36 / $248.52	Facility		$115.59	$197.36	$248.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.32 / $184.60 / $231.42	Professional		$139.32	$184.60	$231.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $457.85 / $457.85 / $457.85	Facility		$457.85	$457.85	$457.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.46 / $190.36 / $243.37	Professional		$141.46	$190.36	$243.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $118.04 / $185.22 / $244.69	Professional		$118.04	$185.22	$244.69