Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.73 / $244.76 / $654.33	Facility		$83.73	$244.76	$654.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.48 / $75.23 / $396.12	Professional		$62.48	$75.23	$396.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.68 / $169.57 / $231.28	Facility		$104.68	$169.57	$231.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $73.93 / $115.73	Professional		$46.18	$73.93	$115.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.41 / $156.97 / $169.36	Professional		$64.41	$156.97	$169.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $49.88 / $64.41 / $193.85	Facility		$49.88	$64.41	$193.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.41 / $71.56 / $92.75	Professional		$64.41	$71.56	$92.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.97 / $67.63 / $142.19	Facility		$57.97	$67.63	$142.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.40 / $77.29 / $186.79	Facility		$58.40	$77.29	$186.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.41 / $80.51 / $105.46	Professional		$64.41	$80.51	$105.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.60 / $198.80 / $266.10	Facility		$125.60	$198.80	$266.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $82.11 / $158.36	Professional		$57.65	$82.11	$158.36
United Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $27.05 / $89.99	Professional		$27.05	$27.05	$89.99