Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $177.83 / $223.87	Facility		$95.50	$177.83	$223.87
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	25	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $229.09	Professional		$58.88	$83.18	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $263.03	Professional		$97.72	$154.88	$263.03
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $186.21	Professional		$112.20	$151.36	$186.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $125.89 / $223.87	Facility		$70.79	$125.89	$223.87
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	25	$199.53	$199.53	$199.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $204.17	Professional		$67.61	$117.49	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $138.04 / $158.49	Facility		$100.00	$138.04	$158.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $109.65 / $165.96	Facility		$67.61	$109.65	$165.96
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	22	$147.91	$147.91	$147.91
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	AS	$12.30	$12.30	$12.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $144.54 / $213.80	Professional		$79.43	$144.54	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $218.78	Professional		$125.89	$181.97	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $208.93	Professional		$77.62	$128.82	$208.93