Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.11 / $183.24 / $3,377.40	Facility		$124.11	$183.24	$3,377.40
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $2,805.94 / $2,805.94 / $4,145.67	Facility	25	$2,805.94	$2,805.94	$4,145.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $145.41 / $332.00	Professional		$73.06	$145.41	$332.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.44 / $94.44 / $94.44	Facility		$94.44	$94.44	$94.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.37 / $188.63 / $271.61	Professional		$107.37	$188.63	$271.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.34 / $172.16 / $192.60	Professional		$127.34	$172.16	$192.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.14 / $201.44 / $283.44	Facility		$109.14	$201.44	$283.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $177.32 / $260.99	Professional		$131.29	$177.32	$260.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.54 / $163.59 / $194.11	Facility		$120.54	$163.59	$194.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $82.93 / $201.44 / $283.44	Facility		$82.93	$201.44	$283.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.68 / $199.50 / $253.38	Professional		$139.68	$199.50	$253.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $202.09 / $265.42	Professional		$143.91	$202.09	$265.42
United Facility/Professional Professional Modifier Low / Median / High Price $125.21 / $187.20 / $266.91	Professional		$125.21	$187.20	$266.91