Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $162.18	Professional		$77.62	$114.82	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $75.86 / $120.23	Facility		$50.12	$75.86	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $446.68	Professional		$117.49	$173.78	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $416.87	Professional		$275.42	$346.74	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.88 / $309.03	Facility		$104.71	$154.88	$309.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $162.18	Professional		$77.62	$131.83	$162.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $323.59 / $331.13	Facility		$229.09	$323.59	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $151.36 / $288.40	Facility		$100.00	$151.36	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $363.08	Professional		$79.43	$109.65	$363.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $389.05 / $676.08	Facility		$251.19	$389.05	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $446.68	Professional		$173.78	$204.17	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $346.74	Professional		$134.90	$165.96	$346.74