Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.36 / $216.82 / $398.53	Facility		$137.36	$216.82	$398.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $98.36 / $281.13 / $882.96	Facility	25	$98.36	$281.13	$882.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.39 / $187.94 / $495.00	Professional		$98.39	$187.94	$495.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $117.33 / $224.89 / $522.00	Professional	25	$117.33	$224.89	$522.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $191.64 / $191.64 / $246.60	Facility		$191.64	$191.64	$246.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.03 / $273.35 / $469.01	Professional		$132.03	$273.35	$469.01
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $883.00 / $883.00 / $883.00	Professional		$883.00	$883.00	$883.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.35 / $350.30 / $435.96	Professional		$272.35	$350.30	$435.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $137.91 / $223.38 / $351.05	Facility		$137.91	$223.38	$351.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $187.80 / $258.11 / $455.17	Professional		$187.80	$258.11	$455.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.94 / $275.37 / $363.14	Facility		$178.94	$275.37	$363.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $139.53 / $226.98 / $424.79	Facility		$139.53	$226.98	$424.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.66 / $331.50 / $454.00	Professional		$204.66	$331.50	$454.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.52 / $131.52 / $131.52	Facility		$131.52	$131.52	$131.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $235.09 / $335.69 / $468.83	Professional		$235.09	$335.69	$468.83
United Facility/Professional Professional Modifier Low / Median / High Price $189.06 / $276.77 / $472.52	Professional		$189.06	$276.77	$472.52