Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $676.08 / $1,380.38	Facility		$338.84	$676.08	$1,380.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $870.96 / $3,311.31 / $5,370.32	Facility	25	$870.96	$3,311.31	$5,370.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $851.14	Professional		$181.97	$263.03	$851.14
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $346.74 / $1,023.29	Professional	25	$190.55	$346.74	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $436.52 / $691.83	Professional		$218.78	$436.52	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $501.19 / $724.44	Professional		$380.19	$501.19	$724.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $338.84 / $562.34	Facility		$208.93	$338.84	$562.34
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $851.14 / $3,090.30 / $5,370.32	Facility	25	$851.14	$3,090.30	$5,370.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $691.83	Professional		$251.19	$457.09	$691.83
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $331.13 / $912.01	Professional	25	$190.55	$331.13	$912.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $524.81 / $549.54	Facility		$371.54	$524.81	$549.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $537.03	Facility		$199.53	$323.59	$537.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $501.19 / $691.83	Professional		$199.53	$501.19	$691.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,311.31	Facility		$3,162.28	$3,162.28	$3,311.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $691.83	Professional		$371.54	$501.19	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $676.08	Professional		$275.42	$467.74	$676.08