Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.40 / $146.62 / $283.14	Facility		$126.40	$146.62	$283.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $151.68 / $300.00	Professional		$73.64	$151.68	$300.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.33 / $253.06 / $433.23	Facility		$164.33	$253.06	$433.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.62 / $111.67 / $181.52	Professional		$106.62	$111.67	$181.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $222.30 / $266.38	Professional		$101.12	$222.30	$266.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.84 / $106.18 / $222.46	Facility		$75.84	$106.18	$222.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $101.12 / $136.51	Professional		$101.12	$101.12	$136.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.12 / $106.18 / $223.22	Facility		$101.12	$106.18	$223.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.18 / $127.92 / $253.06	Facility		$106.18	$127.92	$253.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.01 / $116.29 / $145.61	Professional		$108.01	$116.29	$145.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $197.18 / $307.70 / $396.99	Facility		$197.18	$307.70	$396.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $178.35 / $198.71 / $317.61	Professional		$178.35	$198.71	$317.61
United Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $42.47 / $106.18	Professional		$42.47	$42.47	$106.18