Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $229.09 / $575.44	Facility		$138.04	$229.09	$575.44
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $104.71 / $316.23 / $977.24	Facility	25	$104.71	$316.23	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $489.78	Professional		$95.50	$181.97	$489.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $107.15 / $213.80 / $524.81	Professional	25	$107.15	$213.80	$524.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $426.58	Professional		$120.23	$239.88	$426.58
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $354.81 / $891.25	Professional		$331.13	$354.81	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $457.09	Professional		$223.87	$316.23	$457.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $186.21 / $331.13	Facility		$117.49	$186.21	$331.13
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $107.15 / $302.00 / $977.24	Facility	25	$107.15	$302.00	$977.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $416.87	Professional		$125.89	$229.09	$416.87
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $107.15 / $218.78 / $489.78	Professional	25	$107.15	$218.78	$489.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $295.12 / $363.08	Facility		$199.53	$295.12	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $177.83 / $302.00	Facility		$114.82	$177.83	$302.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $295.12 / $446.68	Professional		$87.10	$295.12	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $436.52	Professional		$204.17	$309.03	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $346.74	Professional		$128.82	$229.09	$346.74