Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $234.42 / $630.96	Facility		$138.04	$234.42	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $204.17	Professional		$89.13	$104.71	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $416.87	Facility		$234.42	$234.42	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $154.88 / $257.04	Professional		$67.61	$154.88	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $309.03 / $371.54	Professional		$141.25	$309.03	$371.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $295.12	Facility		$141.25	$141.25	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $199.53	Professional		$102.33	$141.25	$199.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $213.80	Facility		$141.25	$141.25	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $416.87	Facility		$107.15	$199.53	$416.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $213.80	Professional		$107.15	$158.49	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $426.58 / $588.84	Facility		$213.80	$426.58	$588.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $169.82	Professional		$114.82	$120.23	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $229.09	Facility		$169.82	$169.82	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $169.82	Professional		$60.26	$60.26	$169.82