Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.74 / $398.74 / $695.78	Facility		$398.74	$398.74	$695.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $155.15 / $155.15	Professional		$115.16	$155.15	$155.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $259.93 / $400.28 / $464.75	Facility		$259.93	$400.28	$464.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $183.79 / $229.73	Professional		$159.91	$183.79	$229.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.94 / $389.66 / $420.43	Professional		$159.94	$389.66	$420.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.17 / $159.94 / $333.57	Facility		$83.17	$159.94	$333.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $159.94 / $159.94 / $215.93	Professional		$159.94	$159.94	$215.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $159.94 / $167.95 / $223.93	Facility		$159.94	$167.95	$223.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.17 / $159.94 / $421.08	Facility		$83.17	$159.94	$421.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.94 / $175.95 / $223.93	Professional		$151.94	$175.95	$223.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $430.89 / $517.91 / $627.91	Facility		$430.89	$517.91	$627.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $143.09 / $190.79 / $394.66	Professional		$143.09	$190.79	$394.66
United Facility/Professional Professional Modifier Low / Median / High Price $67.18 / $67.18 / $191.94	Professional		$67.18	$67.18	$191.94