Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.25 / $196.14 / $212.93	Facility		$183.25	$196.14	$212.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.11 / $88.69 / $231.96	Professional		$58.11	$88.69	$231.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.11 / $494.06 / $615.02	Facility		$79.11	$494.06	$615.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $150.80 / $242.71	Professional		$69.37	$150.80	$242.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.77 / $196.31 / $228.11	Professional		$164.77	$196.31	$228.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.01 / $137.62 / $194.97	Facility		$72.01	$137.62	$194.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.94 / $137.47 / $265.25	Professional		$104.94	$137.47	$265.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.93 / $142.12 / $170.85	Facility		$95.93	$142.12	$170.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.80 / $173.40 / $266.14	Facility		$77.80	$173.40	$266.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $178.00 / $247.35	Professional		$118.00	$178.00	$247.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $513.61 / $658.66 / $821.41	Facility		$513.61	$658.66	$821.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.71 / $174.95 / $241.71	Professional		$128.71	$174.95	$241.71
United Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $99.41 / $238.77	Professional		$70.43	$99.41	$238.77