Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.69 / $762.09 / $5,325.48	Facility		$228.69	$762.09	$5,325.48
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $869.32 / $2,254.54 / $4,985.28	Facility	25	$869.32	$2,254.54	$4,985.28
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $169.79 / $510.37 / $800.95	Professional	25	$169.79	$510.37	$800.95
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
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.06 / $365.34 / $438.30	Professional		$278.06	$365.34	$438.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.77 / $313.72 / $446.97	Facility		$169.77	$313.72	$446.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $240.10 / $328.30 / $348.40	Facility		$240.10	$328.30	$348.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $176.43 / $329.60 / $447.07	Facility		$176.43	$329.60	$447.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,816.98 / $2,136.60 / $2,666.35	Facility		$1,816.98	$2,136.60	$2,666.35