Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $218.78 / $426.58	Facility		$117.49	$218.78	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $194.98	Professional		$67.61	$89.13	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $251.19 / $331.13	Facility		$154.88	$251.19	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $169.82	Professional		$70.79	$104.71	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $204.17 / $251.19	Professional		$95.50	$204.17	$251.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $128.82	Facility		$95.50	$95.50	$128.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $134.90	Professional		$95.50	$102.33	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $194.98	Facility		$95.50	$95.50	$194.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $131.83 / $281.84	Facility		$85.11	$131.83	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $147.91	Professional		$79.43	$107.15	$147.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $281.84 / $389.05	Facility		$141.25	$281.84	$389.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $81.28 / $114.82	Professional		$75.86	$81.28	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Facility		$114.82	$114.82	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $114.82	Professional		$39.81	$52.48	$114.82