Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.58 / $2,747.00 / $7,920.26	Facility		$197.58	$2,747.00	$7,920.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.19 / $124.79 / $329.50	Professional		$83.19	$124.79	$329.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Facility		$78.00	$78.00	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.07 / $197.30 / $321.52	Professional		$115.07	$197.30	$321.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.19 / $238.54 / $308.55	Professional		$189.19	$238.54	$308.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.54 / $195.50 / $270.02	Facility		$123.54	$195.50	$270.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $187.20 / $290.70	Professional		$144.41	$187.20	$290.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.41 / $205.15 / $249.91	Facility		$137.41	$205.15	$249.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.54 / $200.49 / $312.33	Facility		$123.54	$200.49	$312.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $159.25 / $222.58 / $316.20	Professional		$159.25	$222.58	$316.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,539.74 / $4,494.80 / $5,709.03	Facility		$3,539.74	$4,494.80	$5,709.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.60 / $238.79 / $327.36	Professional		$163.60	$238.79	$327.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.50 / $219.08 / $350.48	Professional		$162.50	$219.08	$350.48