Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.39 / $132.18 / $255.25	Facility		$109.39	$132.18	$255.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $494.60	Professional		$88.43	$88.43	$494.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.13 / $239.96 / $319.13	Facility		$148.13	$239.96	$319.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.11 / $104.90 / $163.31	Professional		$64.11	$104.90	$163.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $222.44 / $240.00	Professional		$91.16	$222.44	$240.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $104.27 / $320.82	Facility		$88.43	$104.27	$320.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $109.39 / $131.27	Professional		$91.16	$109.39	$131.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.16 / $109.39 / $201.24	Facility		$91.16	$109.39	$201.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.16 / $110.30 / $264.36	Facility		$91.16	$110.30	$264.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $109.39 / $149.24	Professional		$91.16	$109.39	$149.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.76 / $281.38 / $376.62	Facility		$177.76	$281.38	$376.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $116.21 / $224.82	Professional		$81.68	$116.21	$224.82
United Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $52.11 / $109.39	Professional		$38.29	$52.11	$109.39