Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $263.03 / $6,606.93	Facility		$114.82	$263.03	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	50	$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $87.10 / $257.04	Professional		$48.98	$87.10	$257.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $128.82 / $416.87	Professional	50	$74.13	$128.82	$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 $67.61 / $123.03 / $229.09	Professional		$67.61	$123.03	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $239.88	Professional		$87.10	$131.83	$239.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $107.15 / $263.03	Facility		$51.29	$107.15	$263.03
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	50	$794.33	$794.33	$794.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $234.42	Professional		$79.43	$141.25	$234.42
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $128.82 / $436.52	Professional	50	$74.13	$128.82	$436.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $165.96 / $181.97	Facility		$117.49	$165.96	$181.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $107.15 / $194.98	Facility		$57.54	$107.15	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $223.87	Professional		$79.43	$128.82	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $229.09	Professional		$97.72	$154.88	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $4,073.80 / $6,165.95	Facility		$389.05	$4,073.80	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $218.78	Professional		$77.62	$128.82	$218.78