Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $254.38 / $295.08 / $569.79	Facility		$254.38	$295.08	$569.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.52 / $173.50 / $396.83	Professional		$146.52	$173.50	$396.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $330.70 / $509.28 / $591.29	Facility		$330.70	$509.28	$591.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.41 / $224.42 / $364.81	Professional		$178.41	$224.42	$364.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $446.72 / $535.34	Professional		$203.50	$446.72	$535.34
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $152.63 / $213.68 / $447.70	Facility		$152.63	$213.68	$447.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $203.50 / $274.73	Professional		$203.50	$203.50	$274.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $213.68 / $449.23	Facility		$203.50	$213.68	$449.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $213.68 / $257.43 / $541.99	Facility		$213.68	$257.43	$541.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $216.24 / $234.03 / $305.25	Professional		$216.24	$234.03	$305.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $396.83 / $619.25 / $840.74	Facility		$396.83	$619.25	$840.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $359.70 / $400.13 / $640.54	Professional		$359.70	$400.13	$640.54
United Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $203.50 / $203.50	Facility		$203.50	$203.50	$203.50
United Facility/Professional Professional Modifier Low / Median / High Price $85.47 / $85.47 / $221.66	Professional		$85.47	$85.47	$221.66