Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.82 / $213.82 / $497.77	Facility		$213.82	$213.82	$497.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.62 / $83.20 / $85.77	Professional		$68.62	$83.20	$85.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.95 / $286.36 / $332.48	Facility		$185.95	$286.36	$332.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $131.75 / $2,893.04	Professional		$55.75	$131.75	$2,893.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $279.23 / $301.27	Professional		$114.43	$279.23	$301.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.89 / $114.43 / $178.88	Facility		$42.89	$114.43	$178.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $98.64 / $125.87 / $155.62	Professional		$98.64	$125.87	$155.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.99 / $128.16 / $200.25	Facility		$102.99	$128.16	$200.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.89 / $102.92 / $230.74	Facility		$42.89	$102.92	$230.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.77 / $94.35 / $122.65	Professional		$85.77	$94.35	$122.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $171.54 / $261.00 / $400.51	Facility		$171.54	$261.00	$400.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.54 / $136.72 / $282.25	Professional		$102.54	$136.72	$282.25
United Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $40.03 / $102.92	Professional		$36.02	$40.03	$102.92