Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $323.59 / $537.03	Facility		$223.87	$323.59	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $309.03	Professional		$223.87	$234.42	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $309.03 / $436.52	Facility		$213.80	$309.03	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $245.47	Professional		$223.87	$223.87	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $489.78 / $575.44	Professional		$223.87	$489.78	$575.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $239.88 / $446.68	Facility		$223.87	$239.88	$446.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $295.12	Professional		$223.87	$239.88	$295.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $281.84 / $467.74	Facility		$223.87	$281.84	$467.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $239.88 / $436.52	Facility		$229.09	$239.88	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $223.87 / $263.03	Professional		$79.43	$223.87	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $257.04 / $645.65	Facility		$223.87	$257.04	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $537.03	Facility		$223.87	$223.87	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87