Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $244.99 / $250.56 / $251.53	Facility		$244.99	$250.56	$251.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $108.27 / $250.56	Professional		$74.56	$108.27	$250.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.42 / $1,018.62 / $1,233.81	Facility		$93.42	$1,018.62	$1,233.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $196.54 / $314.75	Professional		$106.25	$196.54	$314.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $193.81 / $230.36 / $266.83	Professional		$193.81	$230.36	$266.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.60 / $182.85 / $259.76	Facility		$93.60	$182.85	$259.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $156.91 / $178.08 / $311.93	Professional		$156.91	$178.08	$311.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $130.82 / $188.50 / $213.06	Facility		$130.82	$188.50	$213.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.49 / $238.70 / $352.80	Facility		$109.49	$238.70	$352.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.07 / $234.46 / $314.75	Professional		$161.07	$234.46	$314.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,076.15 / $1,345.62 / $1,577.58	Facility		$1,076.15	$1,345.62	$1,577.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $185.60 / $226.04 / $311.02	Professional		$185.60	$226.04	$311.02
United Facility/Professional Professional Modifier Low / Median / High Price $99.18 / $124.01 / $328.16	Professional		$99.18	$124.01	$328.16