Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.34 / $330.59 / $487.63	Facility		$158.34	$330.59	$487.63
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $206.88 / $598.63 / $1,149.00	Facility	25	$206.88	$598.63	$1,149.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $257.97 / $688.16	Professional		$156.97	$257.97	$688.16
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $166.73 / $289.87 / $725.00	Professional	25	$166.73	$289.87	$725.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $242.44 / $242.44 / $287.20	Facility		$242.44	$242.44	$287.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.10 / $366.45 / $574.01	Professional		$190.10	$366.45	$574.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $343.06 / $427.86 / $532.47	Professional		$343.06	$427.86	$532.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $188.28 / $314.64 / $489.02	Facility		$188.28	$314.64	$489.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $267.38 / $355.99 / $576.10	Professional		$267.38	$355.99	$576.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $262.69 / $387.26 / $443.54	Facility		$262.69	$387.26	$443.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $189.23 / $322.36 / $534.74	Facility		$189.23	$322.36	$534.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $291.24 / $419.52 / $560.04	Professional		$291.24	$419.52	$560.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $187.52 / $187.52 / $187.52	Facility		$187.52	$187.52	$187.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $297.32 / $423.36 / $586.20	Professional		$297.32	$423.36	$586.20
United Facility/Professional Professional Modifier Low / Median / High Price $269.10 / $393.93 / $636.30	Professional		$269.10	$393.93	$636.30
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00