Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $457.09 / $512.86	Facility		$169.82	$457.09	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $338.84	Professional		$190.55	$190.55	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $416.87 / $489.78	Professional		$190.55	$416.87	$489.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $204.17 / $239.88	Facility		$190.55	$204.17	$239.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $239.88	Professional		$190.55	$190.55	$239.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $181.97 / $309.03	Facility		$147.91	$181.97	$309.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $275.42 / $478.63	Facility		$190.55	$275.42	$478.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $190.55 / $223.87	Professional		$79.43	$190.55	$223.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $234.42 / $575.44	Facility		$223.87	$234.42	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $204.17	Professional		$190.55	$204.17	$204.17