Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $251.19 / $309.03	Facility		$169.82	$251.19	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $288.40	Professional		$79.43	$114.82	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $645.65 / $831.76	Facility		$109.65	$645.65	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $331.13	Professional		$97.72	$208.93	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $309.03	Professional		$213.80	$245.47	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $165.96 / $251.19	Facility		$100.00	$165.96	$251.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $338.84	Professional		$147.91	$213.80	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $199.53 / $234.42	Facility		$147.91	$199.53	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $295.12	Facility		$104.71	$169.82	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $331.13	Professional		$165.96	$229.09	$331.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $776.25 / $954.99	Facility		$660.69	$776.25	$954.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $234.42 / $309.03	Professional		$181.97	$234.42	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $891.25 / $1,174.90	Facility		$724.44	$891.25	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $309.03	Professional		$95.50	$123.03	$309.03