Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.61 / $195.61 / $195.61	Facility		$195.61	$195.61	$195.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $133.00 / $765.62	Professional		$133.00	$133.00	$765.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $160.96	Facility		$160.96	$160.96	$160.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.82 / $160.96 / $197.85	Professional		$136.82	$160.96	$197.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.62 / $218.08 / $627.12	Professional		$169.62	$218.08	$627.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $133.00 / $304.33 / $349.05	Facility		$133.00	$304.33	$349.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $235.26 / $331.60	Professional		$27.55	$235.26	$331.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $242.31 / $276.36 / $340.87	Facility		$242.31	$276.36	$340.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $242.31 / $250.59 / $307.07	Professional		$242.31	$250.59	$307.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.00 / $289.85 / $404.74	Facility		$133.00	$289.85	$404.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $233.43 / $291.05	Professional		$160.96	$233.43	$291.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $375.15 / $375.15 / $441.28	Facility		$375.15	$375.15	$441.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $254.36 / $254.36 / $254.36	Professional		$254.36	$254.36	$254.36
United Facility/Professional Professional Modifier Low / Median / High Price $125.95 / $125.95 / $246.37	Professional		$125.95	$125.95	$246.37