Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $619.50 / $619.50 / $1,081.02	Facility		$619.50	$619.50	$1,081.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.90 / $183.90 / $472.17	Professional		$183.90	$183.90	$472.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $403.83 / $403.83 / $722.04	Facility		$403.83	$403.83	$722.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.81 / $198.81 / $198.81	Professional		$198.81	$198.81	$198.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $248.51 / $545.44 / $653.63	Professional		$248.51	$545.44	$653.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $186.38 / $241.05 / $546.72	Facility		$186.38	$241.05	$546.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $248.51 / $248.51 / $335.49	Professional		$248.51	$248.51	$335.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $248.51 / $273.36 / $434.89	Facility		$248.51	$273.36	$434.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $241.05 / $329.28 / $605.90	Facility		$241.05	$329.28	$605.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $273.36 / $273.36 / $347.91	Professional		$273.36	$273.36	$347.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $497.02 / $756.22 / $975.63	Facility		$497.02	$756.22	$975.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $396.92 / $488.60 / $781.23	Professional		$396.92	$488.60	$781.23
United Facility/Professional Professional Modifier Low / Median / High Price $104.37 / $104.37 / $260.94	Professional		$104.37	$104.37	$260.94