Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.06 / $334.12 / $633.96	Facility		$167.06	$334.12	$633.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.73 / $172.18 / $1,124.66	Professional		$168.73	$172.18	$1,124.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.83 / $699.29 / $977.70	Facility		$160.83	$699.29	$977.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $184.95	Professional		$170.48	$170.48	$184.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.57 / $366.47 / $1,300.44	Professional		$164.57	$366.47	$1,300.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $243.79 / $627.52	Facility		$33.90	$243.79	$627.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $180.70 / $221.62	Professional		$170.48	$180.70	$221.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $167.06 / $208.83 / $821.31	Facility		$167.06	$208.83	$821.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $160.83 / $623.15 / $997.04	Facility		$160.83	$623.15	$997.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $184.95 / $327.11 / $623.15	Professional		$184.95	$327.11	$623.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $461.64 / $782.71 / $1,569.30	Facility		$461.64	$782.71	$1,569.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
United Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $204.58	Professional		$170.48	$170.48	$204.58