Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $707.95	Professional		$245.47	$288.40	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $562.34 / $660.69	Professional		$263.03	$562.34	$660.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $288.40 / $338.84	Facility		$269.15	$288.40	$338.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $489.78	Professional		$257.04	$295.12	$489.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $263.03 / $489.78	Facility		$251.19	$263.03	$489.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $389.05 / $758.58	Facility		$251.19	$389.05	$758.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $269.15 / $316.23	Professional		$79.43	$269.15	$316.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $794.33 / $1,000.00	Facility		$380.19	$794.33	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $288.40	Professional		$269.15	$288.40	$288.40