Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.28 / $157.13 / $176.26	Facility		$149.28	$157.13	$176.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $100.89 / $393.56	Professional		$45.82	$100.89	$393.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,084.56 / $1,084.56 / $1,084.56	Facility		$1,084.56	$1,084.56	$1,084.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.33 / $167.00 / $208.48	Professional		$123.33	$167.00	$208.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.01 / $167.68 / $178.93	Professional		$75.01	$167.68	$178.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.89 / $157.94 / $237.38	Facility		$100.89	$157.94	$237.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $140.25 / $214.50	Professional		$114.24	$140.25	$214.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.60 / $140.44 / $184.68	Facility		$116.60	$140.44	$184.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $245.84 / $245.84 / $602.39	Professional		$245.84	$245.84	$602.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.91 / $181.06 / $243.80	Facility		$151.91	$181.06	$243.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.16 / $170.24 / $198.18	Professional		$110.16	$170.24	$198.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,037.60 / $1,258.55 / $1,551.28	Facility		$1,037.60	$1,258.55	$1,551.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $132.93 / $169.13 / $199.92	Professional		$132.93	$169.13	$199.92
United Facility/Professional Professional Modifier Low / Median / High Price $62.58 / $84.68 / $224.48	Professional		$62.58	$84.68	$224.48