Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.38 / $154.16 / $175.19	Facility		$138.38	$154.16	$175.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.19 / $76.67 / $366.93	Professional		$72.19	$76.67	$366.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.62 / $162.53 / $211.43	Professional		$102.62	$162.53	$211.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $163.50 / $186.05	Professional		$113.02	$163.50	$186.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $76.67 / $131.75 / $195.30	Facility		$76.67	$131.75	$195.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $108.80 / $121.20 / $225.99	Professional		$108.80	$121.20	$225.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.43 / $133.33 / $144.05	Facility		$86.43	$133.33	$144.05
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $61.59 / $69.43	Professional		$44.75	$61.59	$69.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $76.67 / $152.19 / $181.06	Facility		$76.67	$152.19	$181.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $162.94 / $210.40	Professional		$122.40	$162.94	$210.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $468.03 / $608.69 / $745.96	Facility		$468.03	$608.69	$745.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.77 / $176.41 / $224.88	Professional		$129.77	$176.41	$224.88
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $155.03 / $224.48	Professional		$106.00	$155.03	$224.48