Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.78 / $283.61 / $342.22	Facility		$152.78	$283.61	$342.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.89 / $128.26 / $238.33	Professional		$103.89	$128.26	$238.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.60 / $305.83 / $392.66	Facility		$198.60	$305.83	$392.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $158.97 / $239.63	Professional		$70.22	$158.97	$239.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $268.47 / $321.70	Professional		$122.22	$268.47	$321.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.67 / $128.33 / $268.88	Facility		$91.67	$128.33	$268.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $122.22 / $165.00	Professional		$122.22	$122.22	$165.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $122.22 / $231.36	Facility		$122.22	$122.22	$231.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $154.61 / $354.44	Facility		$128.33	$154.61	$354.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $147.88 / $195.55	Professional		$134.44	$147.88	$195.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $238.33 / $377.23 / $504.94	Facility		$238.33	$377.23	$504.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $216.06 / $240.22 / $384.75	Professional		$216.06	$240.22	$384.75
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $63.37 / $128.33	Professional		$51.33	$63.37	$128.33