Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $176.35 / $254.90	Facility		$126.24	$176.35	$254.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $128.72 / $219.66	Professional		$127.45	$128.72	$219.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.24 / $188.46 / $262.92	Facility		$120.24	$188.46	$262.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $138.27	Professional		$127.45	$127.45	$138.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $276.99 / $350.63	Professional		$124.39	$276.99	$350.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $127.45 / $182.25 / $274.02	Facility		$127.45	$182.25	$274.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $140.19 / $165.69	Professional		$127.45	$140.19	$165.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $157.80 / $378.72	Facility		$126.24	$157.80	$378.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.05 / $147.46 / $266.36	Facility		$141.05	$147.46	$266.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $156.31 / $177.78	Professional		$127.45	$156.31	$177.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $127.45 / $205.59 / $463.88	Facility		$127.45	$205.59	$463.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $127.45	Professional		$127.45	$127.45	$127.45
United Facility/Professional Professional Modifier Low / Median / High Price $127.45 / $127.45 / $146.57	Professional		$127.45	$127.45	$146.57