Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.50 / $749.90 / $5,116.62	Facility		$129.50	$749.90	$5,116.62
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.17 / $132.66 / $746.98	Facility	52	$61.17	$132.66	$746.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $150.55 / $569.12	Professional		$70.76	$150.55	$569.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.58 / $189.57 / $393.55	Professional		$108.58	$189.57	$393.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.50 / $161.57 / $355.33	Professional		$129.50	$161.57	$355.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.44 / $183.77 / $357.14	Facility		$81.44	$183.77	$357.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.25 / $230.26 / $332.95	Professional		$109.25	$230.26	$332.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $150.75 / $263.83 / $303.51	Facility		$150.75	$263.83	$303.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.44 / $186.75 / $394.40	Facility		$81.44	$186.75	$394.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.04 / $213.40 / $358.15	Professional		$119.04	$213.40	$358.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,722.06 / $2,201.77 / $2,738.85	Facility		$1,722.06	$2,201.77	$2,738.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.42 / $206.93 / $377.10	Professional		$120.42	$206.93	$377.10
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 $196.10 / $289.42 / $419.49	Professional		$196.10	$289.42	$419.49