Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $239.88	Professional		$125.89	$158.49	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $575.44 / $707.95	Professional		$213.80	$575.44	$707.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $316.23	Facility		$165.96	$208.93	$316.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $223.87 / $302.00	Professional		$204.17	$223.87	$302.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $269.15 / $354.81	Facility		$218.78	$269.15	$354.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $275.42 / $354.81	Professional		$251.19	$275.42	$354.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $239.88 / $363.08	Facility		$138.04	$239.88	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $239.88 / $295.12	Professional		$87.10	$239.88	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $389.05 / $1,071.52	Facility		$229.09	$389.05	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $309.03 / $309.03	Professional		$281.84	$309.03	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $223.87 / $575.44	Facility		$131.83	$223.87	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $251.19	Professional		$120.23	$131.83	$251.19