Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $156.75 / $214.23	Facility		$156.75	$156.75	$214.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.24 / $150.52 / $229.30	Professional		$111.24	$150.52	$229.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.80 / $199.80 / $199.80	Facility		$199.80	$199.80	$199.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.98 / $291.89 / $430.56	Professional		$174.98	$291.89	$430.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.42 / $275.83 / $378.48	Professional		$187.42	$275.83	$378.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $115.67 / $178.35 / $324.82	Facility		$115.67	$178.35	$324.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $175.64 / $251.94 / $365.64	Professional		$175.64	$251.94	$365.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $192.96 / $305.63 / $324.95	Facility		$192.96	$305.63	$324.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.08 / $175.98 / $335.40	Facility		$115.08	$175.98	$335.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $142.35 / $236.68 / $382.67	Professional		$142.35	$236.68	$382.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.40 / $260.82 / $390.80	Professional		$180.40	$260.82	$390.80
United Facility/Professional Professional Modifier Low / Median / High Price $249.60 / $345.30 / $513.88	Professional		$249.60	$345.30	$513.88