Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $436.52 / $1,288.25	Facility		$354.81	$436.52	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $213.80 / $436.52	Professional		$91.20	$213.80	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $831.76	Facility		$467.74	$467.74	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $281.84 / $512.86	Professional		$57.54	$281.84	$512.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $616.60 / $724.44	Professional		$281.84	$616.60	$724.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $389.05	Professional		$138.04	$281.84	$389.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $537.03	Facility		$281.84	$281.84	$537.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $398.11 / $831.76	Facility		$141.25	$398.11	$831.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $281.84 / $398.11	Professional		$79.43	$281.84	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $831.76 / $1,122.02	Facility		$426.58	$831.76	$1,122.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $239.88 / $338.84	Professional		$104.71	$239.88	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $457.09	Facility		$338.84	$338.84	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $120.23 / $338.84	Professional		$57.54	$120.23	$338.84