Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.11 / $902.65 / $7,920.26	Facility		$122.11	$902.65	$7,920.26
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $63.63 / $76.90 / $125.86	Facility	52	$63.63	$76.90	$125.86
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.45 / $30.76 / $50.34	Facility	53	$25.45	$30.76	$50.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $151.83 / $466.00	Professional		$85.32	$151.83	$466.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.65 / $60.55 / $216.44	Professional	52	$36.65	$60.55	$216.44
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $14.66 / $24.22 / $103.14	Professional	53	$14.66	$24.22	$103.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.03 / $182.96 / $271.94	Professional		$119.03	$182.96	$271.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.34 / $160.38 / $241.36	Professional		$117.34	$160.38	$241.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $73.31 / $168.83 / $264.35	Facility		$73.31	$168.83	$264.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.98 / $167.28 / $275.52	Professional		$106.98	$167.28	$275.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.45 / $187.60 / $208.76	Facility		$117.45	$187.60	$208.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $73.31 / $201.87 / $264.35	Facility		$73.31	$201.87	$264.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.14 / $188.81 / $273.55	Professional		$123.14	$188.81	$273.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $468.03 / $608.69 / $745.96	Facility		$468.03	$608.69	$745.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $188.20 / $289.93	Professional		$121.71	$188.20	$289.93
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 $148.40 / $234.83 / $325.54	Professional		$148.40	$234.83	$325.54