Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.42 / $277.82 / $6,629.40	Facility		$99.42	$277.82	$6,629.40
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.97 / $25.27 / $55.56	Facility	53	$20.97	$25.27	$55.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $113.52 / $519.96	Professional		$48.90	$113.52	$519.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.93 / $122.49 / $329.02	Professional	50	$69.93	$122.49	$329.02
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 $80.61 / $138.19 / $297.69	Professional		$80.61	$138.19	$297.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.74 / $130.96 / $269.64	Professional		$104.74	$130.96	$269.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.09 / $150.72 / $253.05	Facility		$70.09	$150.72	$253.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.47 / $160.19 / $262.11	Professional		$85.47	$160.19	$262.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.83 / $180.30 / $223.78	Facility		$99.83	$180.30	$223.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.09 / $156.76 / $337.03	Facility		$70.09	$156.76	$337.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $156.82 / $286.61	Professional		$96.85	$156.82	$286.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $98.38 / $162.00 / $308.27	Professional		$98.38	$162.00	$308.27
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $148.01 / $198.33 / $352.03	Professional		$148.01	$198.33	$352.03