Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.95 / $356.67 / $617.41	Facility		$256.95	$356.67	$617.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $269.95 / $616.52	Professional		$175.00	$269.95	$616.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $210.64 / $296.08 / $772.00	Professional	25	$210.64	$296.08	$772.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.45 / $456.22 / $727.35	Professional		$252.45	$456.22	$727.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.67 / $428.64 / $660.68	Professional		$269.67	$428.64	$660.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $176.28 / $269.95 / $508.11	Facility		$176.28	$269.95	$508.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $279.00 / $392.20 / $640.79	Professional		$279.00	$392.20	$640.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $276.17 / $460.29 / $562.79	Facility		$276.17	$460.29	$562.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $269.95 / $513.36	Facility		$175.00	$269.95	$513.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.76 / $359.55 / $621.49	Professional		$203.76	$359.55	$621.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $326.76 / $412.99 / $506.13	Facility		$326.76	$412.99	$506.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.82 / $421.17 / $657.30	Professional		$288.82	$421.17	$657.30
United Facility/Professional Professional Modifier Low / Median / High Price $339.99 / $453.43 / $865.32	Professional		$339.99	$453.43	$865.32