Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $549.54 / $2,344.23	Facility		$144.54	$549.54	$2,344.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $524.81 / $954.99 / $3,019.95	Facility	25	$524.81	$954.99	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $380.19	Professional		$89.13	$131.83	$380.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $257.04 / $489.78	Professional	25	$100.00	$257.04	$489.78
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 $114.82 / $229.09 / $338.84	Professional		$114.82	$229.09	$338.84
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $316.23	Professional		$213.80	$263.03	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $309.03	Professional		$194.98	$245.47	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $181.97 / $363.08	Facility		$114.82	$181.97	$363.08
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $489.78 / $954.99 / $2,884.03	Facility	25	$489.78	$954.99	$2,884.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $213.80 / $323.59	Professional		$112.20	$213.80	$323.59
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $107.15 / $251.19 / $467.74	Professional	25	$107.15	$251.19	$467.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $223.87 / $239.88	Facility		$165.96	$223.87	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $302.00	Facility		$109.65	$169.82	$302.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $234.42 / $323.59	Professional		$79.43	$234.42	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,905.46	Facility		$1,584.89	$1,584.89	$1,905.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $323.59	Professional		$177.83	$239.88	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $316.23	Professional		$134.90	$229.09	$316.23