Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $326.80 / $326.80 / $768.94	Facility		$326.80	$326.80	$768.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.58 / $319.11 / $330.64	Professional		$307.58	$319.11	$330.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $653.60 / $653.60 / $653.60	Facility		$653.60	$653.60	$653.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.80 / $326.80 / $326.80	Professional		$326.80	$326.80	$326.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $319.11 / $384.47 / $587.16	Facility		$319.11	$384.47	$587.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $582.19 / $79,999.20 / $79,999.20	Facility		$582.19	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $319.11 / $384.47 / $502.60	Facility		$319.11	$384.47	$502.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $326.80 / $400.45 / $438.89	Professional		$326.80	$400.45	$438.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $320.12 / $543.38 / $1,236.23	Facility		$320.12	$543.38	$1,236.23
United Facility/Professional Professional Modifier Low / Median / High Price $320.39 / $320.39 / $368.45	Professional		$320.39	$320.39	$368.45