Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.10 / $1,824.00 / $2,229.39	Facility		$139.10	$1,824.00	$2,229.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.43 / $79.97 / $164.61	Professional		$68.43	$79.97	$164.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $525.00 / $1,478.00 / $1,863.00	Facility		$525.00	$1,478.00	$1,863.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $134.15 / $184.04	Professional		$74.34	$134.15	$184.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.70 / $148.60 / $178.00	Professional		$126.70	$148.60	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.38 / $111.14 / $180.25	Facility		$70.38	$111.14	$180.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.59 / $127.10 / $176.62	Professional		$106.59	$127.10	$176.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.84 / $136.68 / $140.69	Facility		$98.84	$136.68	$140.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.38 / $117.35 / $181.06	Facility		$70.38	$117.35	$181.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $147.69 / $189.58	Professional		$111.78	$147.69	$189.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,918.67 / $2,257.26 / $2,695.31	Facility		$1,918.67	$2,257.26	$2,695.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.49 / $153.72 / $198.13	Professional		$127.49	$153.72	$198.13
United Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $900.00 / $900.00	Facility		$900.00	$900.00	$900.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.68 / $137.29 / $203.06	Professional		$95.68	$137.29	$203.06