Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $398.11 / $6,606.93	Facility		$199.53	$398.11	$6,606.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $371.54	Professional		$95.50	$162.18	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $426.58	Professional		$128.82	$223.87	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $398.11	Professional		$165.96	$251.19	$398.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $194.98 / $501.19	Facility		$100.00	$194.98	$501.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $398.11	Professional		$158.49	$269.15	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $309.03 / $331.13	Facility		$223.87	$309.03	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $190.55 / $354.81	Facility		$107.15	$190.55	$354.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $416.87	Professional		$125.89	$257.04	$416.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,187.76 / $2,691.53	Facility		$1,737.80	$2,187.76	$2,691.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $295.12 / $407.38	Professional		$186.21	$295.12	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,951.21 / $7,413.10	Facility		$1,096.48	$2,951.21	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $398.11	Professional		$147.91	$239.88	$398.11