Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $79.43	Professional		$40.74	$57.54	$79.43
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.98 / $48.98 / $48.98	Professional	25	$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $120.23	Professional		$102.33	$102.33	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $36.31 / $131.83	Professional		$33.88	$36.31	$131.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $79.43 / $104.71	Facility		$28.18	$79.43	$104.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $120.23	Professional		$48.98	$91.20	$120.23
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $48.98 / $48.98 / $48.98	Professional	25	$48.98	$48.98	$48.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $89.13 / $104.71	Facility		$74.13	$89.13	$104.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $79.43 / $109.65	Facility		$28.18	$79.43	$109.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $131.83	Professional		$70.79	$87.10	$131.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $91.20	Professional		$74.13	$77.62	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $158.49	Professional		$54.95	$104.71	$158.49