Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.37 / $3,213.00 / $7,920.26	Facility		$120.37	$3,213.00	$7,920.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $126.15 / $319.45	Professional		$52.98	$126.15	$319.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.90 / $178.98 / $351.76	Professional		$104.90	$178.98	$351.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $172.07 / $314.30	Professional		$119.20	$172.07	$314.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.47 / $188.06 / $328.80	Facility		$87.47	$188.06	$328.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $196.28 / $347.86	Professional		$98.74	$196.28	$347.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.48 / $232.76 / $258.62	Facility		$114.48	$232.76	$258.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.47 / $197.30 / $331.23	Facility		$87.47	$197.30	$331.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.10 / $188.10 / $352.48	Professional		$116.10	$188.10	$352.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,382.73 / $9,212.20 / $12,052.68	Facility		$7,382.73	$9,212.20	$12,052.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $116.53 / $207.40 / $365.74	Professional		$116.53	$207.40	$365.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.85 / $277.41 / $410.65	Professional		$191.85	$277.41	$410.65