Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.00 / $221.50 / $734.87	Facility		$147.00	$221.50	$734.87
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $131.21 / $589.45 / $1,007.34	Facility	25	$131.21	$589.45	$1,007.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.19 / $120.76 / $408.40	Professional		$94.19	$120.76	$408.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $101.25 / $235.48 / $818.00	Professional	25	$101.25	$235.48	$818.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.08 / $223.91 / $311.88	Professional		$119.08	$223.91	$311.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.51 / $247.05 / $298.86	Professional		$199.51	$247.05	$298.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $176.41 / $281.26	Facility		$109.76	$176.41	$281.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $171.60 / $206.47 / $296.24	Professional		$171.60	$206.47	$296.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $156.65 / $226.63 / $239.86	Facility		$156.65	$226.63	$239.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $110.12 / $182.90 / $294.95	Facility		$110.12	$182.90	$294.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $201.00 / $245.15 / $313.27	Professional		$201.00	$245.15	$313.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $185.45 / $253.29 / $324.70	Professional		$185.45	$253.29	$324.70
United Facility/Professional Professional Modifier Low / Median / High Price $167.52 / $242.76 / $360.72	Professional		$167.52	$242.76	$360.72
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $85.00 / $144.66	Professional	25	$80.00	$85.00	$144.66