Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.92 / $164.06 / $256.50	Facility		$112.92	$164.06	$256.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $138.62 / $388.60 / $428.04	Facility	25	$138.62	$388.60	$428.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $126.22 / $344.00	Professional		$79.00	$126.22	$344.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.73 / $136.72 / $364.63	Professional	25	$76.73	$136.72	$364.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $109.51 / $146.68	Facility		$109.51	$109.51	$146.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $174.33 / $289.93	Professional		$81.84	$174.33	$289.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.91 / $209.28 / $275.07	Professional		$154.91	$209.28	$275.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.61 / $159.11 / $250.29	Facility		$91.61	$159.11	$250.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $179.87 / $272.26	Professional		$124.12	$179.87	$272.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.85 / $202.34 / $224.45	Facility		$126.85	$202.34	$224.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.32 / $159.11 / $284.11	Facility		$92.32	$159.11	$284.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $203.77 / $283.91	Professional		$138.88	$203.77	$283.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $98.88 / $98.88 / $98.88	Facility		$98.88	$98.88	$98.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.35 / $200.20 / $293.04	Professional		$136.35	$200.20	$293.04
United Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $200.86 / $344.97	Professional		$112.84	$200.86	$344.97