Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.64 / $110.21 / $213.53	Facility		$72.64	$110.21	$213.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $115.44 / $167.04 / $285.08	Facility	25	$115.44	$167.04	$285.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.19 / $85.03 / $245.93	Professional		$48.19	$85.03	$245.93
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.39 / $96.07 / $254.00	Professional	25	$59.39	$96.07	$254.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $62.64 / $94.71	Facility		$62.64	$62.64	$94.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.18 / $112.18 / $190.22	Professional		$57.18	$112.18	$190.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.02 / $121.54 / $177.12	Professional		$89.02	$121.54	$177.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.90 / $106.92 / $168.64	Facility		$58.90	$106.92	$168.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $115.29 / $174.68	Professional		$75.00	$115.29	$174.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.80 / $135.19 / $145.38	Facility		$85.80	$135.19	$145.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.06 / $110.22 / $184.49	Facility		$59.06	$110.22	$184.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.75 / $128.56 / $184.49	Professional		$88.75	$128.56	$184.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $68.16 / $68.16 / $68.16	Facility		$68.16	$68.16	$68.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.07 / $125.78 / $194.30	Professional		$83.07	$125.78	$194.30
United Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $143.38 / $221.19	Professional		$96.00	$143.38	$221.19