Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.17 / $4,704.00 / $8,728.00	Facility		$123.17	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $86.66 / $231.19	Professional		$61.92	$86.66	$231.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.79 / $127.28 / $165.21	Professional		$82.79	$127.28	$165.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.32 / $128.12 / $144.25	Professional		$89.32	$128.12	$144.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.97 / $137.78 / $204.93	Facility		$74.97	$137.78	$204.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $90.21 / $131.19 / $179.32	Professional		$90.21	$131.19	$179.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $80.43 / $109.21 / $140.16	Facility		$80.43	$109.21	$140.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.97 / $144.16 / $1,738.00	Facility		$74.97	$144.16	$1,738.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.83 / $134.40 / $168.35	Professional		$100.83	$134.40	$168.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,722.06 / $2,201.77 / $2,613.15	Facility		$1,722.06	$2,201.77	$2,613.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $103.32 / $137.84 / $176.23	Professional		$103.32	$137.84	$176.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $121.91 / $178.73	Professional		$86.40	$121.91	$178.73