Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.88 / $209.85 / $4,283.46	Facility		$54.88	$209.85	$4,283.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $25.18 / $30.80 / $77.67	Facility	52	$25.18	$30.80	$77.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $80.13 / $289.00	Professional		$30.75	$80.13	$289.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.23 / $43.29 / $83.39	Professional	52	$16.23	$43.29	$83.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $82.55 / $173.11	Professional		$44.47	$82.55	$173.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $68.70 / $152.38	Professional		$46.76	$68.70	$152.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.56 / $86.69 / $181.80	Facility		$32.56	$86.69	$181.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $98.74 / $169.88	Professional		$41.90	$98.74	$169.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.87 / $116.58 / $131.99	Facility		$51.87	$116.58	$131.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.56 / $86.69 / $175.77	Facility		$32.56	$86.69	$175.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $82.04 / $169.42	Professional		$48.47	$82.04	$169.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $307.31 / $396.76 / $478.20	Facility		$307.31	$396.76	$478.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $85.26 / $174.34	Professional		$47.91	$85.26	$174.34
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 $95.71 / $144.16 / $195.75	Professional		$95.71	$144.16	$195.75