Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.61 / $168.40 / $196.02	Facility		$152.61	$168.40	$196.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.55 / $86.58 / $196.02	Professional		$63.55	$86.58	$196.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.53 / $141.28 / $221.31	Professional		$83.53	$141.28	$221.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.59 / $160.49 / $190.63	Professional		$129.59	$160.49	$190.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $71.70 / $116.50 / $193.26	Facility		$71.70	$116.50	$193.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $124.89 / $177.28	Professional		$84.77	$124.89	$177.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.70 / $148.59 / $160.80	Facility		$98.70	$148.59	$160.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $71.94 / $118.62 / $200.33	Facility		$71.94	$118.62	$200.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.24 / $142.80 / $203.15	Professional		$92.24	$142.80	$203.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $146.65 / $214.38 / $307.12	Facility		$146.65	$214.38	$307.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $127.90 / $193.96	Professional		$81.70	$127.90	$193.96
United Facility/Professional Professional Modifier Low / Median / High Price $112.32 / $155.34 / $235.15	Professional		$112.32	$155.34	$235.15