Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $251.19 / $6,456.54	Facility		$123.03	$251.19	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $117.49 / $645.65	Professional		$57.54	$117.49	$645.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $338.84 / $1,071.52	Professional	50	$199.53	$338.84	$1,071.52
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 / $147.91 / $288.40	Professional		$79.43	$147.91	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $323.59	Professional		$114.82	$162.18	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $125.89 / $269.15	Facility		$70.79	$125.89	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $295.12	Professional		$97.72	$147.91	$295.12
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $380.19	Professional	50	$199.53	$199.53	$380.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $213.80 / $234.42	Facility		$120.23	$213.80	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $123.03 / $257.04	Facility		$69.18	$123.03	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $147.91 / $288.40	Professional		$79.43	$147.91	$288.40
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 $2,570.40 / $3,311.31 / $4,168.69	Facility	50	$2,570.40	$3,311.31	$4,168.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $173.78 / $288.40	Professional		$109.65	$173.78	$288.40
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 $83.18 / $141.25 / $245.47	Professional		$83.18	$141.25	$245.47