Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $281.84 / $467.74	Facility		$194.98	$281.84	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $251.19	Professional		$194.98	$199.53	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $263.03 / $371.54	Facility		$186.21	$263.03	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $213.80	Professional		$194.98	$194.98	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $416.87 / $489.78	Professional		$194.98	$416.87	$489.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $208.93 / $398.11	Facility		$194.98	$208.93	$398.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $208.93 / $257.04	Professional		$194.98	$208.93	$257.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $194.98 / $331.13	Facility		$181.97	$194.98	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $204.17 / $371.54	Facility		$194.98	$204.17	$371.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $199.53 / $234.42	Professional		$79.43	$199.53	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $295.12 / $575.44	Facility		$169.82	$295.12	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $478.63	Facility		$194.98	$194.98	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98