Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $371.54 / $1,096.48	Facility		$302.00	$371.54	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $446.68	Professional		$162.18	$208.93	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $630.96 / $776.25	Facility		$389.05	$630.96	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $263.03 / $478.63	Professional		$138.04	$263.03	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $524.81 / $630.96	Professional		$239.88	$524.81	$630.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $338.84	Professional		$239.88	$269.15	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $363.08	Facility		$239.88	$239.88	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $338.84 / $707.95	Facility		$218.78	$338.84	$707.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $269.15 / $380.19	Professional		$165.96	$269.15	$380.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $724.44 / $1,000.00	Facility		$363.08	$724.44	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $288.40	Professional		$194.98	$204.17	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $389.05	Facility		$288.40	$288.40	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $288.40	Professional		$102.33	$125.89	$288.40