Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.62 / $142.26 / $247.10	Facility		$109.62	$142.26	$247.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.37 / $138.61 / $284.08	Professional		$102.37	$138.61	$284.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.96 / $250.00 / $250.00	Facility		$231.96	$250.00	$250.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $155.79 / $361.37	Professional		$92.50	$155.79	$361.37
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $142.69 / $142.69 / $142.69	Professional		$142.69	$142.69	$142.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $198.52 / $287.54 / $378.18	Professional		$198.52	$287.54	$378.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $124.17 / $168.96 / $297.97	Facility		$124.17	$168.96	$297.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $166.26 / $234.30 / $363.31	Professional		$166.26	$234.30	$363.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $156.41 / $241.00 / $306.19	Facility		$156.41	$241.00	$306.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $124.37 / $167.95 / $299.88	Facility		$124.37	$167.95	$299.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.88 / $208.20 / $351.59	Professional		$122.88	$208.20	$351.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $82.77 / $82.77 / $82.77	Facility		$82.77	$82.77	$82.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.86 / $205.65 / $339.37	Professional		$141.86	$205.65	$339.37
United Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $194.77 / $382.73	Professional		$110.00	$194.77	$382.73