Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $112.20 / $5,011.87	Facility		$66.07	$112.20	$5,011.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $53.70 / $177.83 / $4,265.80	Facility	50	$53.70	$177.83	$4,265.80
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	52	$32.36	$32.36	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $144.54	Professional		$30.90	$61.66	$144.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $107.15 / $288.40	Professional	50	$47.86	$107.15	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.62 / $38.90 / $42.66	Professional	52	$31.62	$38.90	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $134.90	Professional		$43.65	$83.18	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $114.82	Professional		$50.12	$77.62	$114.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $69.18 / $151.36	Facility		$42.66	$69.18	$151.36
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $53.70 / $125.89 / $4,265.80	Facility	50	$53.70	$125.89	$4,265.80
Moda Health Facility/Professional Facility Modifier 52 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	52	$32.36	$32.36	$32.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $77.62 / $125.89	Professional		$44.67	$77.62	$125.89
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $112.20 / $295.12	Professional	50	$47.86	$112.20	$295.12
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	52	$42.66	$42.66	$42.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $91.20 / $95.50	Facility		$67.61	$91.20	$95.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $64.57 / $107.15	Facility		$38.90	$64.57	$107.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $123.03	Professional		$58.88	$81.28	$123.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $194.98 / $245.47	Facility		$154.88	$194.98	$245.47
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	50	$416.87	$416.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $123.03	Professional		$63.10	$89.13	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,071.52 / $6,165.95	Facility		$218.78	$1,071.52	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $125.89	Professional		$48.98	$81.28	$125.89