Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $257.04 / $758.58	Facility		$208.93	$257.04	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $138.04 / $309.03	Professional		$57.54	$138.04	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $338.84 / $489.78	Facility		$275.42	$338.84	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $186.21 / $302.00	Professional		$36.31	$186.21	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $363.08 / $446.68	Professional		$169.82	$363.08	$446.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $190.55	Facility		$169.82	$169.82	$190.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $234.42	Professional		$162.18	$169.82	$234.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $316.23	Facility		$169.82	$169.82	$316.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $234.42 / $489.78	Facility		$125.89	$234.42	$489.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $186.21 / $245.47	Professional		$79.43	$186.21	$245.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $501.19 / $660.69	Facility		$251.19	$501.19	$660.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $204.17	Professional		$134.90	$144.54	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $269.15	Facility		$204.17	$204.17	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $204.17	Professional		$70.79	$70.79	$204.17