Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $269.15 / $794.33	Facility		$218.78	$269.15	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $316.23	Professional		$114.82	$147.91	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $457.09 / $512.86	Facility		$281.84	$457.09	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $190.55 / $316.23	Professional		$81.28	$190.55	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $371.54 / $457.09	Professional		$173.78	$371.54	$457.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $245.47	Professional		$173.78	$173.78	$245.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $263.03	Facility		$173.78	$173.78	$263.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $245.47 / $512.86	Facility		$158.49	$245.47	$512.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $190.55 / $251.19	Professional		$97.72	$190.55	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $524.81 / $724.44	Facility		$263.03	$524.81	$724.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $208.93	Professional		$141.25	$147.91	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $281.84	Facility		$208.93	$208.93	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $208.93	Professional		$74.13	$74.13	$208.93