Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $234.42	Professional		$104.71	$134.90	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $275.42	Professional		$95.50	$154.88	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $407.38	Professional		$141.25	$245.47	$407.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $295.12	Facility		$141.25	$141.25	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $204.17	Professional		$141.25	$169.82	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $223.87	Facility		$141.25	$141.25	$223.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $204.17 / $309.03	Facility		$125.89	$204.17	$309.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $251.19	Professional		$104.71	$186.21	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $489.78	Facility		$281.84	$281.84	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $169.82	Professional		$109.65	$120.23	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $436.52	Professional		$85.11	$141.25	$436.52