Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.04 / $4,684.68 / $8,728.00	Facility		$198.04	$4,684.68	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.39 / $124.37 / $537.19	Professional		$91.39	$124.37	$537.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.26 / $195.93 / $279.60	Professional		$116.26	$195.93	$279.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $202.07 / $240.66	Professional		$170.00	$202.07	$240.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $99.63 / $151.93 / $267.39	Facility		$99.63	$151.93	$267.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $157.81 / $185.66 / $291.77	Professional		$157.81	$185.66	$291.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.02 / $188.03 / $207.03	Facility		$141.02	$188.03	$207.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.82 / $174.22 / $258.72	Facility		$105.82	$174.22	$258.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $209.51 / $264.04	Professional		$163.21	$209.51	$264.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,093.73 / $1,459.75 / $1,719.25	Facility		$1,093.73	$1,459.75	$1,719.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $176.51 / $224.00 / $271.93	Professional		$176.51	$224.00	$271.93
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $4,113.00 / $6,216.00	Facility		$376.00	$4,113.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $146.50 / $203.94 / $300.32	Professional		$146.50	$203.94	$300.32