Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.79 / $1,530.00 / $7,136.25	Facility		$143.79	$1,530.00	$7,136.25
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,409.75 / $2,409.75 / $3,889.08	Facility	50	$2,409.75	$2,409.75	$3,889.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $177.67 / $713.79	Professional		$54.86	$177.67	$713.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.45 / $183.62 / $494.55	Professional	50	$81.45	$183.62	$494.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.53 / $189.53 / $613.79	Professional		$88.53	$189.53	$613.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.45 / $222.45 / $583.86	Professional		$121.45	$222.45	$583.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.33 / $222.45 / $489.39	Facility		$80.33	$222.45	$489.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.63 / $254.49 / $538.90	Professional		$99.63	$254.49	$538.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.57 / $328.24 / $482.40	Facility		$114.57	$328.24	$482.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.33 / $247.77 / $595.02	Facility		$80.33	$247.77	$595.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.72 / $233.42 / $609.12	Professional		$110.72	$233.42	$609.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $111.88 / $200.48 / $638.00	Professional		$111.88	$200.48	$638.00
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 $248.38 / $343.34 / $627.70	Professional		$248.38	$343.34	$627.70