Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.46 / $212.52 / $377.91	Facility		$174.46	$212.52	$377.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $105.11 / $189.71	Professional		$78.23	$105.11	$189.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $176.58 / $193.50	Facility		$176.58	$176.58	$193.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $120.00 / $261.56	Professional		$77.00	$120.00	$261.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $204.33 / $262.79	Professional		$145.13	$204.33	$262.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $152.74 / $227.48	Facility		$93.00	$152.74	$227.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $173.85 / $252.20	Professional		$115.20	$173.85	$252.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.20 / $195.19 / $205.69	Facility		$120.20	$195.19	$205.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.51 / $150.15 / $241.58	Facility		$94.51	$150.15	$241.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.61 / $160.58 / $255.78	Professional		$92.61	$160.58	$255.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $96.00 / $96.00 / $96.00	Facility		$96.00	$96.00	$96.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $148.00 / $251.89	Professional		$102.31	$148.00	$251.89
United Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $142.56 / $267.64	Professional		$91.77	$142.56	$267.64