Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.36 / $295.91 / $330.30	Facility		$161.36	$295.91	$330.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.39 / $135.55 / $207.64	Professional		$106.39	$135.55	$207.64
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $26.28 / $26.28 / $147.68	Professional	25	$26.28	$26.28	$147.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.68 / $342.88 / $359.58	Professional		$321.68	$342.88	$359.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.97 / $280.51 / $315.39	Professional		$125.97	$280.51	$315.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $189.22 / $270.58 / $406.82	Facility		$189.22	$270.58	$406.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.82 / $226.30 / $421.22	Professional		$194.82	$226.30	$421.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.30 / $244.55 / $265.99	Facility		$178.30	$244.55	$265.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $210.45 / $270.58 / $345.63	Facility		$210.45	$270.58	$345.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.47 / $253.09 / $359.58	Professional		$161.47	$253.09	$359.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.97 / $218.97 / $346.72	Professional		$218.97	$218.97	$346.72
United Facility/Professional Professional Modifier Low / Median / High Price $161.91 / $237.25 / $346.10	Professional		$161.91	$237.25	$346.10