Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.56 / $218.80 / $332.26	Facility		$146.56	$218.80	$332.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.16 / $101.79 / $218.80	Professional		$77.16	$101.79	$218.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.68 / $239.74 / $305.52	Facility		$155.68	$239.74	$305.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $110.80 / $188.24	Professional		$61.09	$110.80	$188.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $210.23 / $251.92	Professional		$95.80	$210.23	$251.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $86.22 / $180.50 / $355.77	Facility		$86.22	$180.50	$355.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $114.96 / $140.08	Professional		$95.80	$114.96	$140.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $100.59 / $211.48	Facility		$95.80	$100.59	$211.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.59 / $121.67 / $277.82	Facility		$100.59	$121.67	$277.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $114.96 / $150.61	Professional		$105.38	$114.96	$150.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.81 / $291.52 / $395.79	Facility		$186.81	$291.52	$395.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.38 / $188.50 / $301.62	Professional		$169.38	$188.50	$301.62
United Facility/Professional Professional Modifier Low / Median / High Price $40.24 / $48.64 / $114.96	Professional		$40.24	$48.64	$114.96