Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.22 / $290.81 / $824.12	Facility		$153.22	$290.81	$824.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.08 / $254.08 / $290.81	Professional		$254.08	$254.08	$290.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.40 / $520.40 / $520.40	Facility		$520.40	$520.40	$520.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $260.20 / $260.20	Professional		$260.20	$260.20	$260.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $571.10 / $682.56 / $742.89	Professional		$571.10	$682.56	$742.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $254.08 / $336.73 / $546.27	Facility		$254.08	$336.73	$546.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $290.81 / $290.81 / $456.27	Facility		$290.81	$290.81	$456.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $254.08 / $346.20 / $553.91	Facility		$254.08	$346.20	$553.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $329.73 / $498.47	Professional		$260.20	$329.73	$498.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $290.81 / $290.81 / $290.81	Professional		$290.81	$290.81	$290.81
United Facility/Professional Professional Modifier Low / Median / High Price $255.10 / $255.10 / $306.12	Professional		$255.10	$255.10	$306.12