Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.88 / $254.65 / $569.79	Facility		$158.88	$254.65	$569.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $111.74 / $238.33	Professional		$94.74	$111.74	$238.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.60 / $305.83 / $438.83	Facility		$198.60	$305.83	$438.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.10 / $158.97 / $219.12	Professional		$107.10	$158.97	$219.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $268.47 / $321.70	Professional		$122.22	$268.47	$321.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $91.67 / $128.33 / $268.88	Facility		$91.67	$128.33	$268.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $134.44 / $166.49	Professional		$122.22	$134.44	$166.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $128.33 / $269.80	Facility		$122.22	$128.33	$269.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $154.61 / $354.44	Facility		$128.33	$154.61	$354.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $151.31 / $195.55	Professional		$134.44	$151.31	$195.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $238.33 / $377.23 / $504.94	Facility		$238.33	$377.23	$504.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $216.06 / $240.22 / $384.75	Professional		$216.06	$240.22	$384.75
United Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $122.22 / $122.22	Facility		$122.22	$122.22	$122.22
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $69.84 / $146.66	Professional		$51.33	$69.84	$146.66