Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.49 / $4,704.00 / $8,728.00	Facility		$240.49	$4,704.00	$8,728.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.77 / $145.71 / $564.98	Professional		$101.77	$145.71	$564.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $247.18 / $339.27	Professional		$163.38	$247.18	$339.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.33 / $255.06 / $287.17	Professional		$177.33	$255.06	$287.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $145.71 / $227.23 / $313.27	Facility		$145.71	$227.23	$313.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $176.46 / $196.42 / $368.15	Professional		$176.46	$196.42	$368.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.28 / $201.67 / $231.15	Facility		$155.28	$201.67	$231.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $145.71 / $242.83 / $313.27	Facility		$145.71	$242.83	$313.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $193.57 / $261.92 / $339.19	Professional		$193.57	$261.92	$339.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,722.06 / $2,201.77 / $2,738.85	Facility		$1,722.06	$2,201.77	$2,738.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $209.72 / $283.07 / $361.91	Professional		$209.72	$283.07	$361.91
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,385.00 / $7,480.00	Facility		$1,106.00	$2,385.00	$7,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $239.40 / $362.80	Professional		$169.00	$239.40	$362.80