Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.70 / $293.70 / $293.70	Facility		$293.70	$293.70	$293.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $195.77 / $1,126.92	Professional		$195.77	$195.77	$1,126.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $243.78 / $243.78	Facility		$243.78	$243.78	$243.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.21 / $243.78 / $297.33	Professional		$207.21	$243.78	$297.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $250.83 / $322.50 / $941.64	Professional		$250.83	$322.50	$941.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $195.77 / $443.67 / $508.84	Facility		$195.77	$443.67	$508.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $347.89 / $483.40	Professional		$41.40	$347.89	$483.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $358.33 / $430.00 / $496.91	Facility		$358.33	$430.00	$496.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $358.33 / $367.94 / $453.52	Professional		$358.33	$367.94	$453.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $195.77 / $373.50 / $590.03	Facility		$195.77	$373.50	$590.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $343.58 / $429.83	Professional		$243.78	$343.58	$429.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $552.19 / $552.19 / $649.52	Facility		$552.19	$552.19	$649.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $374.40 / $374.40 / $374.40	Professional		$374.40	$374.40	$374.40
United Facility/Professional Professional Modifier Low / Median / High Price $187.15 / $187.15 / $359.56	Professional		$187.15	$187.15	$359.56