Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.75 / $172.93 / $232.40	Facility		$103.75	$172.93	$232.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $80.51 / $161.85	Professional		$59.76	$80.51	$161.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $207.71 / $241.16	Facility		$134.88	$207.71	$241.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.83 / $91.69 / $148.63	Professional		$72.83	$91.69	$148.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $182.53 / $218.72	Professional		$83.00	$182.53	$218.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.25 / $83.04 / $182.60	Facility		$62.25	$83.04	$182.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $83.00 / $112.05	Professional		$83.00	$83.00	$112.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $87.15 / $183.22	Facility		$83.00	$87.15	$183.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.04 / $105.00 / $207.71	Facility		$83.04	$105.00	$207.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.80 / $95.45 / $119.52	Professional		$87.80	$95.45	$119.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $161.85 / $252.57 / $342.91	Facility		$161.85	$252.57	$342.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $163.32 / $261.12	Professional		$146.63	$163.32	$261.12
United Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $34.86 / $87.15	Professional		$34.86	$34.86	$87.15