Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.50 / $228.50 / $398.72	Facility		$228.50	$228.50	$398.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $88.91 / $96.19	Professional		$77.91	$88.91	$96.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.94 / $229.38 / $294.50	Facility		$148.94	$229.38	$294.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.58 / $59.58 / $59.58	Professional		$59.58	$59.58	$59.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $200.99 / $240.86	Professional		$91.66	$200.99	$240.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.75 / $88.91 / $201.65	Facility		$68.75	$88.91	$201.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $100.83 / $128.32	Professional		$91.66	$100.83	$128.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $102.66 / $160.41	Facility		$91.66	$102.66	$160.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $88.91 / $121.45 / $265.81	Facility		$88.91	$121.45	$265.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.83 / $109.99 / $142.59	Professional		$100.83	$109.99	$142.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $178.74 / $282.93 / $378.68	Facility		$178.74	$282.93	$378.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $146.21 / $180.33 / $287.77	Professional		$146.21	$180.33	$287.77
United Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $38.50 / $109.99	Professional		$38.50	$38.50	$109.99