Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.91 / $186.66 / $400.00	Facility		$160.91	$186.66	$400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $132.94 / $251.02	Professional		$109.42	$132.94	$251.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.18 / $322.13 / $462.20	Facility		$209.18	$322.13	$462.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $167.33 / $252.48	Professional		$86.93	$167.33	$252.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $282.67 / $338.73	Professional		$128.72	$282.67	$338.73
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $96.55 / $178.56 / $429.94	Facility		$96.55	$178.56	$429.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $143.03 / $182.32	Professional		$128.72	$143.03	$182.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.72 / $135.16 / $284.17	Facility		$128.72	$135.16	$284.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $135.16 / $170.57 / $379.75	Facility		$135.16	$170.57	$379.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $159.37 / $205.96	Professional		$141.60	$159.37	$205.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.02 / $397.30 / $531.84	Facility		$251.02	$397.30	$531.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $227.43 / $253.15 / $405.00	Professional		$227.43	$253.15	$405.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.07 / $73.58 / $154.47	Professional		$54.07	$73.58	$154.47