Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $208.93 / $354.81	Facility		$91.20	$208.93	$354.81
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	50	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $112.20 / $346.74	Professional		$51.29	$112.20	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $309.03 / $741.31	Professional	50	$181.97	$309.03	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $229.09	Professional		$69.18	$125.89	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $199.53	Professional		$79.43	$123.03	$199.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $120.23 / $263.03	Facility		$63.10	$120.23	$263.03
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	50	$144.54	$144.54	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $223.87	Professional		$70.79	$134.90	$223.87
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $309.03 / $741.31	Professional	50	$181.97	$309.03	$741.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $158.49 / $199.53	Facility		$107.15	$158.49	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $109.65 / $239.88	Facility		$56.23	$109.65	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $218.78	Professional		$79.43	$120.23	$218.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $398.11 / $478.63	Facility		$309.03	$398.11	$478.63
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $676.08 / $676.08	Facility	50	$676.08	$676.08	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $218.78	Professional		$91.20	$147.91	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,071.52 / $6,165.95	Facility		$389.05	$1,071.52	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $229.09	Professional		$72.44	$125.89	$229.09