Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.48 / $103.28 / $199.44	Facility		$85.48	$103.28	$199.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $69.09 / $283.94	Professional		$62.60	$69.09	$283.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.75 / $187.52 / $206.96	Facility		$115.75	$187.52	$206.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $75.13 / $128.07	Professional		$37.47	$75.13	$128.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $173.55 / $187.23	Professional		$71.23	$173.55	$187.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $71.23 / $148.54	Facility		$35.61	$71.23	$148.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $78.34 / $109.20	Professional		$71.23	$78.34	$109.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $80.48 / $157.24	Facility		$71.23	$80.48	$157.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $85.48 / $178.26	Facility		$51.88	$85.48	$178.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.67 / $78.34 / $99.72	Professional		$67.67	$78.34	$99.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.90 / $216.75 / $294.27	Facility		$138.90	$216.75	$294.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $66.72 / $175.59	Professional		$53.47	$66.72	$175.59
United Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $29.92 / $85.48	Professional		$29.92	$29.92	$85.48