Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $114.82 / $181.97	Facility		$58.88	$114.82	$181.97
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $114.82 / $158.49 / $281.84	Facility	25	$114.82	$158.49	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $199.53	Professional		$43.65	$83.18	$199.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $95.50 / $257.04	Professional	25	$58.88	$95.50	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $173.78	Professional		$52.48	$93.33	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $177.83	Professional		$74.13	$114.82	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $81.28 / $141.25	Facility		$44.67	$81.28	$141.25
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $114.82 / $158.49 / $281.84	Facility	25	$114.82	$158.49	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $100.00 / $165.96	Professional		$56.23	$100.00	$165.96
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $100.00 / $218.78	Professional	25	$58.88	$100.00	$218.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $141.25 / $144.54	Facility		$102.33	$141.25	$144.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $77.62 / $138.04	Facility		$42.66	$77.62	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $181.97	Professional		$74.13	$114.82	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $177.83	Professional		$83.18	$123.03	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $63.10 / $63.10	Facility		$48.98	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $169.82	Professional		$61.66	$104.71	$169.82