Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.98 / $940.00 / $2,749.50	Facility		$95.98	$940.00	$2,749.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $44.12 / $52.77 / $262.43	Facility	52	$44.12	$52.77	$262.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $192.26 / $479.35	Professional		$44.16	$192.26	$479.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $73.43 / $73.43	Facility		$73.43	$73.43	$73.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $194.10 / $567.28	Professional		$66.47	$194.10	$567.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $119.07 / $512.16	Professional		$87.28	$119.07	$512.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.04 / $207.51 / $457.65	Facility		$57.04	$207.51	$457.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $323.02 / $542.40	Professional		$72.45	$323.02	$542.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $92.74 / $351.83 / $421.43	Facility		$92.74	$351.83	$421.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.04 / $223.36 / $509.78	Facility		$57.04	$223.36	$509.78
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $82.56 / $259.30 / $570.49	Professional		$82.56	$259.30	$570.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $258.50 / $563.89	Professional		$79.95	$258.50	$563.89
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 $212.21 / $385.54 / $615.17	Professional		$212.21	$385.54	$615.17