Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $186.21 / $537.03	Facility		$151.36	$186.21	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $218.78	Professional		$87.10	$114.82	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $239.88 / $346.74	Facility		$194.98	$239.88	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $213.80	Professional		$70.79	$131.83	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $257.04 / $316.23	Professional		$120.23	$257.04	$316.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $134.90	Facility		$120.23	$120.23	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $169.82	Professional		$120.23	$120.23	$169.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $251.19	Facility		$120.23	$120.23	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $165.96 / $346.74	Facility		$107.15	$165.96	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $173.78	Professional		$79.43	$131.83	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $354.81 / $478.63	Facility		$181.97	$354.81	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $144.54	Professional		$95.50	$102.33	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $190.55	Facility		$144.54	$144.54	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $144.54	Professional		$50.12	$50.12	$144.54