Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.43 / $219.84 / $412.12	Facility		$118.43	$219.84	$412.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $137.37 / $196.38	Professional		$77.06	$137.37	$196.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.94 / $237.08 / $329.64	Facility		$153.94	$237.08	$329.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.24 / $119.52 / $169.78	Professional		$83.24	$119.52	$169.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $208.10 / $249.37	Professional		$94.74	$208.10	$249.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $71.06 / $99.48 / $208.43	Facility		$71.06	$99.48	$208.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $94.74 / $127.90	Professional		$94.74	$94.74	$127.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $94.74 / $99.48 / $209.14	Facility		$94.74	$99.48	$209.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $99.48 / $119.85 / $274.75	Facility		$99.48	$119.85	$274.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.21 / $116.72 / $148.55	Professional		$104.21	$116.72	$148.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $184.74 / $288.29 / $391.41	Facility		$184.74	$288.29	$391.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $167.58 / $186.46 / $298.42	Professional		$167.58	$186.46	$298.42
United Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $39.79 / $99.48	Professional		$39.79	$39.79	$99.48