Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $141.25 / $407.38	Facility		$114.82	$141.25	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $141.25	Professional		$63.10	$87.10	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $239.88 / $316.23	Facility		$147.91	$239.88	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $162.18	Professional		$58.88	$91.20	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $194.98 / $234.42	Professional		$91.20	$194.98	$234.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $114.82	Facility		$91.20	$91.20	$114.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $151.36	Professional		$91.20	$114.82	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $173.78	Facility		$91.20	$91.20	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $131.83 / $316.23	Facility		$89.13	$131.83	$316.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $162.18	Professional		$79.43	$100.00	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $275.42 / $380.19	Facility		$138.04	$275.42	$380.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $117.49	Professional		$67.61	$91.20	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $144.54	Facility		$109.65	$109.65	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $128.82	Professional		$38.02	$52.48	$128.82