Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.91 / $237.00 / $395.46	Facility		$205.91	$237.00	$395.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $114.03 / $186.02	Professional		$67.98	$114.03	$186.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.48 / $321.05 / $457.95	Facility		$208.48	$321.05	$457.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.13 / $166.95 / $251.84	Professional		$81.13	$166.95	$251.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.29 / $281.95 / $337.87	Professional		$128.29	$281.95	$337.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $96.22 / $134.69 / $282.24	Facility		$96.22	$134.69	$282.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.29 / $128.29 / $174.76	Professional		$128.29	$128.29	$174.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.29 / $134.69 / $283.20	Facility		$128.29	$134.69	$283.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.69 / $162.29 / $372.04	Facility		$134.69	$162.29	$372.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.12 / $155.22 / $205.26	Professional		$141.12	$155.22	$205.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $250.17 / $395.95 / $530.02	Facility		$250.17	$395.95	$530.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $226.83 / $252.47 / $403.94	Professional		$226.83	$252.47	$403.94
United Facility/Professional Professional Modifier Low / Median / High Price $53.88 / $73.31 / $153.94	Professional		$53.88	$73.31	$153.94