Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $489.78 / $1,584.89	Facility		$97.72	$489.78	$1,584.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $288.40 / $831.76 / $1,737.80	Facility	25	$288.40	$831.76	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $223.87	Professional		$52.48	$72.44	$223.87
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $147.91 / $309.03	Professional	25	$66.07	$147.91	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility		$5,248.07	$5,248.07	$5,248.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $134.90 / $199.53	Professional		$66.07	$134.90	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $194.98	Professional		$114.82	$144.54	$194.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $104.71 / $239.88	Facility		$67.61	$104.71	$239.88
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $288.40 / $851.14 / $1,513.56	Facility	25	$288.40	$851.14	$1,513.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $120.23 / $190.55	Professional		$66.07	$120.23	$190.55
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $147.91 / $323.59	Professional	25	$66.07	$147.91	$323.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $120.23 / $141.25	Facility		$100.00	$120.23	$141.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $93.33 / $162.18	Facility		$66.07	$93.33	$162.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $190.55	Professional		$79.43	$134.90	$190.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,230.27	Facility		$1,023.29	$1,023.29	$1,230.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $190.55	Professional		$104.71	$138.04	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $125.89 / $177.83	Professional		$74.13	$125.89	$177.83