Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.28 / $248.04 / $519.20	Facility		$60.28	$248.04	$519.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $57.39 / $71.83	Professional		$43.50	$57.39	$71.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $163.58 / $207.69	Facility		$100.98	$163.58	$207.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $71.45 / $111.62	Professional		$36.33	$71.45	$111.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $151.46 / $163.40	Professional		$62.14	$151.46	$163.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.50 / $66.31 / $194.22	Facility		$52.50	$66.31	$194.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $71.45 / $89.48	Professional		$62.14	$71.45	$89.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.14 / $68.38 / $137.16	Facility		$62.14	$68.38	$137.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.65 / $74.56 / $180.21	Facility		$64.65	$74.56	$180.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.12 / $68.34 / $95.77	Professional		$62.12	$68.34	$95.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.17 / $189.09 / $256.73	Facility		$121.17	$189.09	$256.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $93.38 / $153.43	Professional		$55.61	$93.38	$153.43
United Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $27.93 / $74.56	Professional		$26.10	$27.93	$74.56