Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.62 / $138.50 / $267.45	Facility		$114.62	$138.50	$267.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $92.65 / $331.91	Professional		$71.77	$92.65	$331.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.22 / $251.46 / $289.89	Facility		$155.22	$251.46	$289.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $105.10 / $171.54	Professional		$57.90	$105.10	$171.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $232.71 / $251.07	Professional		$95.52	$232.71	$251.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $95.52 / $199.20	Facility		$47.76	$95.52	$199.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $109.85 / $128.94	Professional		$95.52	$109.85	$128.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $105.07 / $210.86	Facility		$95.52	$105.07	$210.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $114.62 / $269.75	Facility		$69.56	$114.62	$269.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.49 / $105.07 / $133.72	Professional		$95.49	$105.07	$133.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.26 / $290.67 / $394.63	Facility		$186.26	$290.67	$394.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $99.89 / $235.48	Professional		$82.49	$99.89	$235.48
United Facility/Professional Facility Modifier Low / Median / High Price $49.95 / $49.95 / $95.52	Facility		$49.95	$49.95	$95.52
United Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $46.15 / $114.62	Professional		$40.11	$46.15	$114.62