Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $346.74 / $1,202.26	Facility		$151.36	$346.74	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $199.53	Professional		$81.28	$114.82	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $436.52	Facility		$199.53	$323.59	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $131.83 / $239.88	Professional		$75.86	$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 / $275.42	Facility		$123.03	$123.03	$275.42
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 / $257.04	Facility		$123.03	$123.03	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $354.81	Facility		$109.65	$169.82	$354.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $134.90 / $190.55	Professional		$83.18	$134.90	$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 / $102.33 / $144.54	Professional		$97.72	$102.33	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $194.98	Facility		$144.54	$144.54	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $144.54	Professional		$51.29	$69.18	$144.54