Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.83 / $237.29 / $286.33	Facility		$127.83	$237.29	$286.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.13 / $104.82 / $145.60	Professional		$51.13	$104.82	$145.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.18 / $255.91 / $572.73	Facility		$166.18	$255.91	$572.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $117.40 / $200.44	Professional		$107.76	$117.40	$200.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $224.42 / $268.93	Professional		$102.26	$224.42	$268.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $76.70 / $107.37 / $224.97	Facility		$76.70	$107.37	$224.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $102.26 / $138.05	Professional		$102.26	$102.26	$138.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.26 / $107.37 / $225.74	Facility		$102.26	$107.37	$225.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.37 / $129.36 / $255.91	Facility		$107.37	$129.36	$255.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $122.71 / $200.44	Professional		$112.49	$122.71	$200.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.41 / $311.18 / $401.46	Facility		$199.41	$311.18	$401.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.75 / $200.75 / $321.87	Professional		$180.75	$200.75	$321.87
United Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $42.95 / $107.37	Professional		$42.95	$42.95	$107.37