Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.75 / $5,116.62 / $20,400.00	Facility		$274.75	$5,116.62	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.58 / $296.11 / $947.19	Professional		$176.58	$296.11	$947.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $474.95 / $474.95 / $474.95	Professional	50	$474.95	$474.95	$474.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.60 / $329.84 / $612.97	Professional		$209.60	$329.84	$612.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.48 / $346.38 / $553.44	Professional		$237.48	$346.38	$553.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $353.58 / $712.49	Facility		$176.58	$353.58	$712.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $200.15 / $361.86 / $719.34	Professional		$200.15	$361.86	$719.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $241.40 / $389.31 / $489.19	Facility		$241.40	$389.31	$489.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $213.95 / $457.85 / $3,743.00	Facility		$213.95	$457.85	$3,743.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $237.44 / $373.12 / $623.24	Professional		$237.44	$373.12	$623.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,539.74 / $4,494.80 / $5,709.03	Facility		$3,539.74	$4,494.80	$5,709.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $240.19 / $395.41 / $652.83	Professional		$240.19	$395.41	$652.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $332.75 / $501.24 / $733.02	Professional		$332.75	$501.24	$733.02