Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.70 / $124.80 / $268.52	Facility		$84.70	$124.80	$268.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $73.65 / $343.20	Professional		$37.21	$73.65	$343.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.08 / $175.68 / $225.51	Facility		$114.08	$175.68	$225.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.80 / $91.44 / $137.47	Professional		$42.80	$91.44	$137.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $154.12 / $184.68	Professional		$70.20	$154.12	$184.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.65 / $73.70 / $154.44	Facility		$52.65	$73.70	$154.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $70.20 / $94.77	Professional		$70.20	$70.20	$94.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.20 / $73.70 / $122.85	Facility		$70.20	$73.70	$122.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $73.70 / $88.80 / $203.58	Facility		$73.70	$88.80	$203.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $84.24 / $110.00	Professional		$77.22	$84.24	$110.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $136.88 / $216.65 / $290.02	Facility		$136.88	$216.65	$290.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $138.13 / $220.62	Professional		$123.89	$138.13	$220.62
United Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $36.40 / $84.24	Professional		$29.48	$36.40	$84.24