Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $204.17 / $489.78	Facility		$138.04	$204.17	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $85.11 / $169.82	Professional		$38.02	$85.11	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $288.40 / $316.23	Facility		$177.83	$288.40	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $109.65 / $194.98	Professional		$52.48	$109.65	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $234.42 / $281.84	Professional		$109.65	$234.42	$281.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $147.91	Professional		$74.13	$109.65	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $208.93	Facility		$109.65	$109.65	$208.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $158.49 / $323.59	Facility		$107.15	$158.49	$323.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $154.88	Professional		$74.13	$114.82	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $331.13 / $436.52	Facility		$165.96	$331.13	$436.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $131.83	Professional		$54.95	$93.33	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $173.78	Facility		$131.83	$131.83	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $131.83	Professional		$45.71	$45.71	$131.83