Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.25 / $128.00 / $366.56	Facility		$111.25	$128.00	$366.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.84 / $142.63 / $199.68	Professional		$131.84	$142.63	$199.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.78 / $231.78 / $414.41	Facility		$231.78	$231.78	$414.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.43 / $165.43 / $274.52	Professional		$77.43	$165.43	$274.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $313.20 / $375.32	Professional		$142.63	$313.20	$375.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $142.63 / $306.64	Facility		$115.00	$142.63	$306.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $171.16 / $192.55	Professional		$142.63	$171.16	$192.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $156.88 / $213.95	Facility		$142.63	$156.88	$213.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $149.76 / $180.43 / $361.05	Facility		$149.76	$180.43	$361.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $156.88 / $164.02 / $205.39	Professional		$156.88	$164.02	$205.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $242.65 / $393.72 / $559.91	Facility		$242.65	$393.72	$559.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $251.97 / $280.37 / $448.70	Professional		$251.97	$280.37	$448.70
United Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $66.69 / $158.79	Professional		$59.90	$66.69	$158.79