Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $323.59 / $776.25	Facility		$218.78	$323.59	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $316.23	Professional		$128.82	$162.18	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $457.09 / $616.60	Facility		$281.84	$457.09	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $338.84	Professional		$114.82	$186.21	$338.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $371.54 / $457.09	Professional		$173.78	$371.54	$457.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $363.08	Facility		$173.78	$173.78	$363.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $288.40	Professional		$173.78	$208.93	$288.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $363.08	Facility		$173.78	$173.78	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $269.15 / $524.81	Facility		$165.96	$269.15	$524.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $281.84	Professional		$107.15	$208.93	$281.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $524.81 / $707.95	Facility		$257.04	$524.81	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $208.93	Professional		$141.25	$147.91	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $275.42	Facility		$208.93	$208.93	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $346.74	Professional		$104.71	$141.25	$346.74