Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.72 / $1,758.00 / $13,320.00	Facility		$135.72	$1,758.00	$13,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $110.35 / $304.44	Professional		$80.03	$110.35	$304.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $236.85 / $415.54	Professional		$125.92	$236.85	$415.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.60 / $250.05 / $371.89	Professional		$184.60	$250.05	$371.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $110.35 / $188.41 / $293.12	Facility		$110.35	$188.41	$293.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $135.72 / $216.65 / $456.78	Professional		$135.72	$216.65	$456.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $132.75 / $196.52 / $311.55	Facility		$132.75	$196.52	$311.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.65 / $212.55 / $2,662.00	Facility		$111.65	$212.55	$2,662.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.87 / $251.95 / $415.45	Professional		$165.87	$251.95	$415.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,039.76 / $15,838.63 / $18,619.91	Facility		$12,039.76	$15,838.63	$18,619.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.45 / $287.22 / $442.48	Professional		$186.45	$287.22	$442.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $13,246.00 / $26,404.00	Facility		$2,155.00	$13,246.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $238.91 / $496.83	Professional		$181.39	$238.91	$496.83