Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $348.00 / $6,487.79	Facility		$102.48	$348.00	$6,487.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.86 / $127.28 / $267.49	Professional		$67.86	$127.28	$267.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $109.76 / $109.76	Facility		$109.76	$109.76	$109.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.62 / $165.73 / $344.68	Professional		$95.62	$165.73	$344.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.83 / $170.02 / $313.66	Professional		$126.83	$170.02	$313.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.43 / $154.09 / $263.50	Facility		$78.43	$154.09	$263.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $110.39 / $194.67 / $333.61	Professional		$110.39	$194.67	$333.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $124.62 / $209.94 / $258.62	Facility		$124.62	$209.94	$258.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.36 / $156.04 / $294.69	Facility		$80.36	$156.04	$294.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $187.83 / $337.50	Professional		$120.25	$187.83	$337.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $116.24 / $191.36 / $331.57	Professional		$116.24	$191.36	$331.57
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 $123.79 / $224.70 / $358.26	Professional		$123.79	$224.70	$358.26