Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $346.74 / $549.54	Facility		$141.25	$346.74	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $165.96	Professional		$61.66	$85.11	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $239.88 / $331.13	Facility		$147.91	$239.88	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $165.96	Professional		$70.79	$100.00	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $194.98 / $239.88	Professional		$91.20	$194.98	$239.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $407.38	Facility		$91.20	$91.20	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $131.83	Professional		$87.10	$102.33	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $173.78	Facility		$91.20	$91.20	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $128.82 / $269.15	Facility		$83.18	$128.82	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $144.54	Professional		$79.43	$102.33	$144.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $275.42 / $380.19	Facility		$138.04	$275.42	$380.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $109.65	Professional		$74.13	$77.62	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Facility		$109.65	$109.65	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $109.65	Professional		$38.90	$52.48	$109.65