Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.60 / $149.35 / $288.39	Facility		$123.60	$149.35	$288.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.91 / $99.91 / $558.70	Professional		$99.91	$99.91	$558.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.38 / $271.14 / $367.69	Facility		$167.38	$271.14	$367.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $118.12 / $185.05	Professional		$66.06	$118.12	$185.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $250.83 / $270.64	Professional		$103.00	$250.83	$270.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.67 / $111.45 / $257.45	Facility		$83.67	$111.45	$257.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $123.60 / $169.57	Professional		$103.00	$123.60	$169.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.00 / $135.00 / $227.37	Facility		$103.00	$135.00	$227.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $103.00 / $124.63 / $271.14	Facility		$103.00	$124.63	$271.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $123.60 / $168.65	Professional		$103.00	$123.60	$168.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $200.85 / $317.95 / $425.53	Facility		$200.85	$317.95	$425.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $92.12 / $131.31 / $253.53	Professional		$92.12	$131.31	$253.53
United Facility/Professional Professional Modifier Low / Median / High Price $43.26 / $58.88 / $123.60	Professional		$43.26	$58.88	$123.60