Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $158.68 / $283.20	Facility		$141.00	$158.68	$283.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $147.32 / $245.34	Professional		$141.60	$147.32	$245.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.59 / $192.29 / $273.12	Facility		$133.59	$192.29	$273.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $153.63	Professional		$141.60	$141.60	$153.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.06 / $309.66 / $358.71	Professional		$139.06	$309.66	$358.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $126.67 / $177.95 / $304.44	Facility		$126.67	$177.95	$304.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $150.10 / $184.08	Professional		$141.60	$150.10	$184.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $176.25 / $294.52	Facility		$141.00	$176.25	$294.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $138.66 / $147.41 / $244.12	Facility		$138.66	$147.41	$244.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $153.63 / $169.85	Professional		$103.02	$153.63	$169.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $118.61 / $169.68 / $393.45	Facility		$118.61	$169.68	$393.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $169.92	Professional		$141.60	$141.60	$169.92