Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.51 / $253.48 / $489.47	Facility		$218.51	$253.48	$489.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $148.59 / $332.14	Professional		$104.89	$148.59	$332.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $284.08 / $437.48 / $507.93	Facility		$284.08	$437.48	$507.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $185.83 / $313.70	Professional		$81.44	$185.83	$313.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $383.53 / $459.58	Professional		$174.81	$383.53	$459.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $131.11 / $183.55 / $384.58	Facility		$131.11	$183.55	$384.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $235.99	Professional		$174.81	$174.81	$235.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $183.55 / $262.22	Facility		$174.81	$183.55	$262.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $183.55 / $221.13 / $437.48	Facility		$183.55	$221.13	$437.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $184.41 / $201.03 / $251.73	Professional		$184.41	$201.03	$251.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $340.88 / $531.95 / $722.21	Facility		$340.88	$531.95	$722.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $308.83 / $343.65 / $549.95	Professional		$308.83	$343.65	$549.95
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $73.42 / $183.55	Professional		$73.42	$73.42	$183.55