Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.07 / $155.33 / $224.10	Facility		$89.07	$155.33	$224.10
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $200.00 / $200.00 / $200.00	Facility	25	$200.00	$200.00	$200.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $82.56 / $224.00	Professional		$61.96	$82.56	$224.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $89.96 / $89.96	Facility		$89.96	$89.96	$89.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.72 / $8.72 / $8.72	Facility	AS	$8.72	$8.72	$8.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $147.66 / $211.95	Professional		$78.06	$147.66	$211.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.75 / $166.01 / $185.66	Professional		$122.75	$166.01	$185.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $130.97 / $187.29	Facility		$80.00	$130.97	$187.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $131.19 / $250.40	Professional		$105.06	$131.19	$250.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $92.18 / $135.34 / $156.78	Facility		$92.18	$135.34	$156.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $142.80 / $200.80	Facility		$80.00	$142.80	$200.80
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $8.72 / $8.72 / $8.72	Facility	AS	$8.72	$8.72	$8.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.18 / $158.26 / $200.80	Professional		$109.18	$158.26	$200.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.28 / $187.89 / $245.47	Professional		$129.28	$187.89	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $135.04 / $248.96	Professional		$92.50	$135.04	$248.96