Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.38 / $394.25 / $475.72	Facility		$212.38	$394.25	$475.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.15 / $162.15 / $322.81	Professional		$101.15	$162.15	$322.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $276.10 / $339.59 / $493.67	Facility		$276.10	$339.59	$493.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.03 / $187.31 / $304.89	Professional		$149.03	$187.31	$304.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $372.86 / $446.81	Professional		$169.90	$372.86	$446.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $127.43 / $178.40 / $354.32	Facility		$127.43	$178.40	$354.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $169.90 / $229.37	Professional		$169.90	$169.90	$229.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.90 / $178.40 / $375.05	Facility		$169.90	$178.40	$375.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $178.40 / $214.92 / $373.78	Facility		$178.40	$214.92	$373.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $186.89 / $244.66	Professional		$169.90	$186.89	$244.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $331.31 / $517.01 / $667.01	Facility		$331.31	$517.01	$667.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $299.85 / $334.13 / $533.97	Professional		$299.85	$334.13	$533.97
United Facility/Professional Professional Modifier Low / Median / High Price $54.06 / $71.36 / $178.40	Professional		$54.06	$71.36	$178.40