Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $229.09 / $549.54	Facility		$151.36	$229.09	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $223.87	Professional		$81.28	$104.71	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $389.05	Facility		$199.53	$323.59	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $131.83 / $239.88	Professional		$69.18	$131.83	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $323.59	Professional		$123.03	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $169.82	Professional		$123.03	$134.90	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $181.97	Facility		$123.03	$123.03	$181.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $363.08	Facility		$109.65	$169.82	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $190.55	Professional		$85.11	$138.04	$190.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $363.08 / $501.19	Facility		$181.97	$363.08	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $104.71 / $147.91	Professional		$97.72	$104.71	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $194.98	Facility		$147.91	$147.91	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $147.91	Professional		$51.29	$63.10	$147.91