Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.50 / $217.50 / $420.00	Facility		$187.50	$217.50	$420.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $145.50 / $292.50	Professional		$108.00	$145.50	$292.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.75 / $375.38 / $652.82	Facility		$243.75	$375.38	$652.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.59 / $165.55 / $269.06	Professional		$131.59	$165.55	$269.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $329.55 / $394.91	Professional		$150.00	$329.55	$394.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.50 / $157.50 / $330.00	Facility		$112.50	$157.50	$330.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $202.50	Professional		$150.00	$150.00	$202.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $157.50 / $331.13	Facility		$150.00	$157.50	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $157.50 / $189.75 / $375.38	Facility		$157.50	$189.75	$375.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $159.49 / $180.00 / $294.24	Professional		$159.49	$180.00	$294.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $292.50 / $456.45 / $588.89	Facility		$292.50	$456.45	$588.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $265.14 / $294.66 / $472.15	Professional		$265.14	$294.66	$472.15
United Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $63.00 / $157.50	Professional		$63.00	$63.00	$157.50