Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.68 / $383.14 / $880.56	Facility		$199.68	$383.14	$880.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.71 / $142.63 / $396.51	Professional		$92.71	$142.63	$396.51
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 $142.63 / $171.16 / $324.89	Facility		$142.63	$171.16	$324.89
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 / $142.63 / $270.00	Facility		$142.63	$142.63	$270.00
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 $85.58 / $95.27 / $160.88	Professional		$85.58	$95.27	$160.88