Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $194.98 / $575.44	Facility		$158.49	$194.98	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $234.42	Professional		$85.11	$120.23	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $338.84 / $398.11	Facility		$208.93	$338.84	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $229.09	Professional		$85.11	$141.25	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $275.42 / $338.84	Professional		$128.82	$275.42	$338.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $151.36	Facility		$128.82	$128.82	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $181.97	Professional		$128.82	$151.36	$181.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $245.47	Facility		$128.82	$128.82	$245.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $177.83 / $380.19	Facility		$107.15	$177.83	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $190.55	Professional		$79.43	$141.25	$190.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $380.19 / $524.81	Facility		$190.55	$380.19	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $151.36	Professional		$102.33	$107.15	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $204.17	Facility		$151.36	$151.36	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $151.36	Professional		$53.70	$63.10	$151.36