Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $776.25 / $776.25	Facility		$165.96	$776.25	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $213.80	Professional		$112.20	$131.83	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $501.19	Facility		$281.84	$281.84	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $269.15	Professional		$173.78	$199.53	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $371.54 / $446.68	Professional		$173.78	$371.54	$446.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Facility		$173.78	$173.78	$208.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $234.42	Professional		$173.78	$190.55	$234.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $239.88	Facility		$173.78	$173.78	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $208.93 / $457.09	Facility		$89.13	$208.93	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $190.55 / $239.88	Professional		$79.43	$190.55	$239.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $524.81 / $676.08	Facility		$257.04	$524.81	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $208.93	Professional		$128.82	$158.49	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $275.42	Facility		$208.93	$208.93	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $208.93	Professional		$72.44	$72.44	$208.93