Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $213.80 / $524.81	Facility		$144.54	$213.80	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $218.78	Professional		$85.11	$107.15	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $302.00 / $416.87	Facility		$186.21	$302.00	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $181.97	Professional		$72.44	$123.03	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $245.47 / $302.00	Professional		$114.82	$245.47	$302.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $154.88	Facility		$114.82	$114.82	$154.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $190.55	Professional		$114.82	$138.04	$190.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $218.78	Facility		$114.82	$114.82	$218.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $338.84	Facility		$104.71	$162.18	$338.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $190.55	Professional		$79.43	$128.82	$190.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $346.74 / $478.63	Facility		$173.78	$346.74	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $147.91	Professional		$91.20	$109.65	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $186.21	Facility		$138.04	$138.04	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $162.18	Professional		$48.98	$66.07	$162.18