Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.91 / $488.81 / $1,498.68	Facility		$104.91	$488.81	$1,498.68
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $250.00 / $868.10 / $1,351.00	Facility	25	$250.00	$868.10	$1,351.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.88 / $68.54 / $199.00	Professional		$52.88	$68.54	$199.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $70.06 / $184.58 / $329.31	Professional	25	$70.06	$184.58	$329.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,194.00 / $5,194.00 / $5,194.00	Facility		$5,194.00	$5,194.00	$5,194.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $133.78 / $185.78	Professional		$66.48	$133.78	$185.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.71 / $157.91 / $270.00	Professional		$125.71	$157.91	$270.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.29 / $117.99 / $164.50	Facility		$67.29	$117.99	$164.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $119.44 / $192.01	Professional		$97.44	$119.44	$192.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $84.82 / $120.27 / $141.37	Facility		$84.82	$120.27	$141.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.26 / $122.40 / $182.78	Facility		$68.26	$122.40	$182.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.88 / $147.91 / $189.57	Professional		$110.88	$147.91	$189.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $812.27 / $946.96 / $1,181.75	Facility		$812.27	$946.96	$1,181.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.75 / $157.71 / $195.83	Professional		$114.75	$157.71	$195.83
United Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $128.79 / $198.41	Professional		$88.23	$128.79	$198.41