Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $149.11 / $198.81	Facility		$149.11	$149.11	$198.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.86 / $117.30 / $198.81	Professional		$89.86	$117.30	$198.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.15 / $187.15 / $187.15	Facility		$187.15	$187.15	$187.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $183.63 / $316.64	Professional		$93.75	$183.63	$316.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.56 / $233.08 / $300.23	Professional		$163.56	$233.08	$300.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.89 / $141.03 / $257.30	Facility		$104.89	$141.03	$257.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $200.36 / $296.08	Professional		$153.65	$200.36	$296.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.36 / $206.23 / $242.54	Facility		$141.36	$206.23	$242.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.18 / $141.03 / $258.95	Facility		$105.18	$141.03	$258.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.57 / $184.80 / $288.10	Professional		$108.57	$184.80	$288.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.40 / $102.40 / $102.40	Facility		$102.40	$102.40	$102.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $139.90 / $206.61 / $297.02	Professional		$139.90	$206.61	$297.02
United Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $181.73 / $314.45	Professional		$103.97	$181.73	$314.45