Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.94 / $302.47 / $400.00	Facility		$162.94	$302.47	$400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $122.53 / $254.18	Professional		$110.80	$122.53	$254.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.83 / $326.20 / $467.97	Facility		$211.83	$326.20	$467.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.69 / $169.61 / $255.69	Professional		$87.69	$169.61	$255.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.35 / $286.20 / $342.98	Professional		$130.35	$286.20	$342.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.32 / $222.60 / $434.92	Facility		$117.32	$222.60	$434.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.35 / $144.83 / $197.45	Professional		$130.35	$144.83	$197.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $130.35 / $143.38 / $373.10	Facility		$130.35	$143.38	$373.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $149.90 / $175.97 / $384.53	Facility		$149.90	$175.97	$384.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.38 / $161.37 / $208.56	Professional		$143.38	$161.37	$208.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $254.18 / $402.30 / $538.53	Facility		$254.18	$402.30	$538.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $230.42 / $256.55 / $410.33	Professional		$230.42	$256.55	$410.33
United Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $54.75 / $136.87	Professional		$54.75	$54.75	$136.87