Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $223.87 / $6,606.93	Facility		$120.23	$223.87	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility	50	$1,122.02	$1,122.02	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $120.23 / $239.88	Professional		$57.54	$120.23	$239.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $371.54 / $416.87	Professional	50	$91.20	$371.54	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $269.15	Professional		$79.43	$141.25	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $263.03	Professional		$100.00	$151.36	$263.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $138.04 / $295.12	Facility		$66.07	$138.04	$295.12
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility	50	$1,122.02	$1,122.02	$1,122.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $275.42	Professional		$95.50	$173.78	$275.42
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	50	$91.20	$91.20	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $194.98 / $213.80	Facility		$151.36	$194.98	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $138.04 / $288.40	Facility		$63.10	$138.04	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $151.36 / $263.03	Professional		$79.43	$151.36	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,187.76 / $2,754.23	Facility		$1,737.80	$2,187.76	$2,754.23
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.27 / $3,548.13 / $3,981.07	Facility	50	$2,630.27	$3,548.13	$3,981.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $251.19	Professional		$112.20	$173.78	$251.19
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 $89.13 / $147.91 / $251.19	Professional		$89.13	$147.91	$251.19