Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.70 / $306.70 / $340.71	Facility		$306.70	$306.70	$340.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.92 / $158.37 / $350.09	Professional		$127.92	$158.37	$350.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.81 / $264.67 / $381.08	Professional		$155.81	$264.67	$381.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.19 / $287.70 / $343.07	Professional		$245.19	$287.70	$343.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $134.59 / $208.61 / $378.21	Facility		$134.59	$208.61	$378.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $197.96 / $250.74 / $356.32	Professional		$197.96	$250.74	$356.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $203.49 / $267.61 / $304.18	Facility		$203.49	$267.61	$304.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.59 / $247.38 / $378.21	Facility		$134.59	$247.38	$378.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.49 / $294.70 / $374.44	Professional		$194.49	$294.70	$374.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $713.39 / $1,002.61 / $1,175.01	Facility		$713.39	$1,002.61	$1,175.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $174.25 / $295.10 / $384.56	Professional		$174.25	$295.10	$384.56
United Facility/Professional Professional Modifier Low / Median / High Price $188.96 / $295.47 / $428.98	Professional		$188.96	$295.47	$428.98