Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $134.90 / $398.11	Facility		$109.65	$134.90	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $134.90	Professional		$57.54	$77.62	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $229.09 / $257.04	Facility		$141.25	$229.09	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $87.10 / $158.49	Professional		$42.66	$87.10	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $190.55 / $223.87	Professional		$87.10	$190.55	$223.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $87.10 / $123.03	Facility		$85.11	$87.10	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $123.03	Professional		$87.10	$104.71	$123.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $165.96	Facility		$87.10	$87.10	$165.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $123.03 / $257.04	Facility		$64.57	$123.03	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $123.03	Professional		$79.43	$97.72	$123.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $263.03 / $363.08	Facility		$131.83	$263.03	$363.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $104.71	Professional		$66.07	$79.43	$104.71
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $141.25	Facility		$104.71	$104.71	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $104.71	Professional		$37.15	$37.15	$104.71