Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $363.08 / $812.83	Facility		$169.82	$363.08	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $363.08	Professional		$93.33	$141.25	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $416.87	Facility		$234.42	$234.42	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $158.49 / $275.42	Professional		$72.44	$158.49	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $309.03 / $371.54	Professional		$141.25	$309.03	$371.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $263.03 / $776.25	Facility		$141.25	$263.03	$776.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $204.17	Professional		$141.25	$158.49	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $213.80	Facility		$141.25	$141.25	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $204.17 / $416.87	Facility		$141.25	$204.17	$416.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $213.80	Professional		$141.25	$158.49	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $316.23 / $562.34	Facility		$213.80	$316.23	$562.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $169.82	Professional		$114.82	$120.23	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $229.09	Facility		$169.82	$169.82	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $165.96	Professional		$85.11	$95.50	$165.96