Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.93 / $258.16 / $300.20	Professional		$202.93	$258.16	$300.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.29 / $511.50 / $643.52	Professional		$267.29	$511.50	$643.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.83 / $502.16 / $597.21	Professional		$426.83	$502.16	$597.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $216.05 / $288.01 / $529.94	Facility		$216.05	$288.01	$529.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $388.85 / $465.86 / $473.69	Facility		$388.85	$465.86	$473.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $216.05 / $288.01 / $607.26	Facility		$216.05	$288.01	$607.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $298.77 / $523.74 / $695.25	Professional		$298.77	$523.74	$695.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $389.95 / $520.64 / $618.64	Facility		$389.95	$520.64	$618.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $283.06 / $479.35 / $653.54	Professional		$283.06	$479.35	$653.54
United Facility/Professional Professional Modifier Low / Median / High Price $308.30 / $447.96 / $678.91	Professional		$308.30	$447.96	$678.91