Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.73 / $240.14 / $463.71	Facility		$198.73	$240.14	$463.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $160.63 / $665.87	Professional		$160.63	$160.63	$665.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.13 / $435.98 / $481.20	Facility		$269.13	$435.98	$481.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.10 / $175.68 / $297.25	Professional		$99.10	$175.68	$297.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.61 / $403.88 / $435.74	Professional		$165.61	$403.88	$435.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $118.72 / $169.86 / $365.30	Facility		$118.72	$169.86	$365.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $165.61 / $184.03 / $235.91	Professional		$165.61	$184.03	$235.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.61 / $188.47 / $365.58	Facility		$165.61	$188.47	$365.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $198.73 / $435.98	Facility		$120.62	$198.73	$435.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.61 / $182.17 / $231.85	Professional		$165.61	$182.17	$231.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $322.94 / $503.95 / $684.20	Facility		$322.94	$503.95	$684.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.02 / $172.21 / $408.61	Professional		$138.02	$172.21	$408.61
United Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $77.22 / $198.73	Professional		$69.56	$77.22	$198.73