Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,995.26 / $1,995.26	Facility		$398.11	$1,995.26	$1,995.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $263.03 / $398.11	Professional		$93.33	$263.03	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $162.18 / $478.63	Professional		$57.54	$162.18	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $281.84	Professional		$131.83	$151.36	$281.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $302.00 / $562.34	Facility		$100.00	$302.00	$562.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $263.03 / $398.11	Professional		$93.33	$263.03	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $154.88 / $208.93	Facility		$117.49	$154.88	$208.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $204.17 / $524.81	Facility		$89.13	$204.17	$524.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $169.82 / $478.63	Professional		$79.43	$169.82	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $707.95	Professional		$162.18	$316.23	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $870.96	Professional		$257.04	$389.05	$870.96