Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.10 / $396.72 / $1,718.40	Facility		$155.10	$396.72	$1,718.40
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $485.08 / $1,199.96 / $4,727.85	Facility	25	$485.08	$1,199.96	$4,727.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.12 / $132.00 / $343.50	Professional		$90.12	$132.00	$343.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $99.38 / $282.95 / $546.51	Professional	25	$99.38	$282.95	$546.51
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 $123.88 / $230.86 / $325.52	Professional		$123.88	$230.86	$325.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $214.15 / $268.80 / $333.15	Professional		$214.15	$268.80	$333.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $116.57 / $216.38 / $304.92	Facility		$116.57	$216.38	$304.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $174.68 / $209.61 / $322.57	Professional		$174.68	$209.61	$322.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.07 / $222.44 / $240.53	Facility		$162.07	$222.44	$240.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $124.34 / $223.52 / $307.20	Facility		$124.34	$223.52	$307.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.07 / $255.43 / $325.42	Professional		$209.07	$255.43	$325.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,265.04 / $1,488.28 / $1,857.60	Facility		$1,265.04	$1,488.28	$1,857.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $198.96 / $276.57 / $332.64	Professional		$198.96	$276.57	$332.64
United Facility/Professional Professional Modifier Low / Median / High Price $162.24 / $236.59 / $349.40	Professional		$162.24	$236.59	$349.40