Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.35 / $126.09 / $243.49	Facility		$104.35	$126.09	$243.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.35 / $104.01 / $545.24	Professional		$84.35	$104.01	$545.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.30 / $228.91 / $306.79	Facility		$141.30	$228.91	$306.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $99.95 / $156.26	Professional		$59.50	$99.95	$156.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $212.18 / $228.93	Professional		$86.96	$212.18	$228.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.33 / $109.31 / $319.55	Facility		$63.33	$109.31	$319.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $100.00 / $142.61	Professional		$86.96	$100.00	$142.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.96 / $108.70 / $191.96	Facility		$86.96	$108.70	$191.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.33 / $109.31 / $252.18	Facility		$63.33	$109.31	$252.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $104.35 / $142.36	Professional		$86.96	$104.35	$142.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $169.57 / $268.38 / $359.27	Facility		$169.57	$268.38	$359.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $110.84 / $214.15	Professional		$77.92	$110.84	$214.15
United Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $49.70 / $104.35	Professional		$36.52	$49.70	$104.35