Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.58 / $204.30 / $225.70	Facility		$191.58	$204.30	$225.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $102.21 / $225.70	Professional		$78.42	$102.21	$225.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.86 / $170.48 / $255.84	Professional		$96.86	$170.48	$255.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.99 / $195.15 / $228.86	Professional		$162.99	$195.15	$228.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $85.80 / $127.66 / $224.28	Facility		$85.80	$127.66	$224.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $153.12 / $209.39	Professional		$104.34	$153.12	$209.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $118.40 / $173.58 / $181.57	Facility		$118.40	$173.58	$181.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $130.63 / $230.72	Facility		$86.21	$130.63	$230.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.43 / $170.26 / $235.09	Professional		$111.43	$170.26	$235.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $165.68 / $243.57 / $354.16	Facility		$165.68	$243.57	$354.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.34 / $160.53 / $240.67	Professional		$102.34	$160.53	$240.67
United Facility/Professional Professional Modifier Low / Median / High Price $118.18 / $175.50 / $276.47	Professional		$118.18	$175.50	$276.47