Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $363.08 / $549.54	Facility		$117.49	$363.08	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $223.87	Professional		$81.28	$104.71	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $354.81	Facility		$199.53	$199.53	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $323.59	Professional		$123.03	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $181.97	Facility		$123.03	$123.03	$181.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $169.82	Professional		$114.82	$134.90	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $134.90 / $213.80	Facility		$109.65	$134.90	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $363.08	Facility		$109.65	$169.82	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $181.97	Professional		$79.43	$134.90	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $363.08 / $478.63	Facility		$213.80	$363.08	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $104.71 / $147.91	Professional		$97.72	$104.71	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $194.98	Facility		$147.91	$147.91	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $147.91	Professional		$51.29	$63.10	$147.91