Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $288.40 / $549.54	Facility		$154.88	$288.40	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $218.78	Professional		$91.20	$114.82	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $446.68	Facility		$199.53	$323.59	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $223.87	Professional		$95.50	$134.90	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $323.59	Professional		$123.03	$263.03	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $169.82	Facility		$123.03	$123.03	$169.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $173.78	Professional		$123.03	$138.04	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $234.42	Facility		$123.03	$123.03	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $173.78 / $363.08	Facility		$112.20	$173.78	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $138.04 / $194.98	Professional		$79.43	$138.04	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $371.54 / $512.86	Facility		$186.21	$371.54	$512.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $147.91	Professional		$100.00	$104.71	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $199.53	Facility		$147.91	$147.91	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $147.91	Professional		$52.48	$70.79	$147.91