Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.15 / $147.15 / $147.15	Facility		$147.15	$147.15	$147.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.31 / $111.31 / $640.77	Professional		$111.31	$111.31	$640.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $123.59	Facility		$123.59	$123.59	$123.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $123.59 / $155.94	Professional		$105.05	$123.59	$155.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.93 / $174.77 / $471.76	Professional		$135.93	$174.77	$471.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $111.31 / $276.80 / $317.45	Facility		$111.31	$276.80	$317.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $188.53 / $250.51	Professional		$25.12	$188.53	$250.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $175.94 / $223.32 / $310.02	Facility		$175.94	$223.32	$310.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $175.94 / $194.19 / $260.77	Professional		$175.94	$194.19	$260.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.31 / $198.16 / $317.45	Facility		$111.31	$198.16	$317.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $195.33 / $247.26	Professional		$123.59	$195.33	$247.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $313.98 / $313.98 / $369.32	Facility		$313.98	$313.98	$369.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $212.82 / $212.82 / $212.82	Professional		$212.82	$212.82	$212.82
United Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $95.59 / $191.18	Professional		$95.59	$95.59	$191.18