Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $215.37 / $376.74 / $794.18	Facility		$215.37	$376.74	$794.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $236.91 / $554.89	Professional		$182.45	$236.91	$554.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $260.63 / $381.52	Facility		$172.12	$260.63	$381.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $197.94	Professional		$182.45	$182.45	$197.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $429.69 / $497.74	Professional		$182.45	$429.69	$497.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $226.51 / $392.27	Facility		$144.00	$226.51	$392.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $193.39 / $237.19	Professional		$182.45	$193.39	$237.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $228.06 / $407.24	Facility		$182.45	$228.06	$407.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $260.89 / $392.27	Facility		$172.12	$260.89	$392.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.16 / $200.19 / $240.38	Professional		$147.16	$200.19	$240.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $197.32 / $303.14 / $712.86	Facility		$197.32	$303.14	$712.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $182.45	Professional		$182.45	$182.45	$182.45
United Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $182.45	Professional		$182.45	$182.45	$182.45