Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.20 / $144.19 / $282.45	Facility		$89.20	$144.19	$282.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.66 / $76.45 / $162.19	Professional		$64.66	$76.45	$162.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.78 / $185.99 / $261.20	Facility		$120.78	$185.99	$261.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.18 / $94.48 / $133.35	Professional		$65.18	$94.48	$133.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $163.36 / $195.75	Professional		$74.33	$163.36	$195.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $55.75 / $78.05 / $163.53	Facility		$55.75	$78.05	$163.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $80.83 / $100.35	Professional		$74.33	$80.83	$100.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.33 / $78.05 / $164.08	Facility		$74.33	$78.05	$164.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.05 / $94.03 / $215.56	Facility		$78.05	$94.03	$215.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $89.94 / $116.68	Professional		$81.76	$89.94	$116.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $144.94 / $226.19 / $307.08	Facility		$144.94	$226.19	$307.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.07 / $146.31 / $233.41	Professional		$131.07	$146.31	$233.41
United Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $78.05	Professional		$31.22	$31.22	$78.05