Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $295.12 / $489.78	Facility		$204.17	$295.12	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $1,445.44	Professional		$204.17	$251.19	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $288.40 / $407.38	Facility		$194.98	$288.40	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $204.17 / $223.87	Professional		$199.53	$204.17	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $245.47 / $524.81	Professional		$144.54	$245.47	$524.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $218.78 / $407.38	Facility		$204.17	$218.78	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $512.86	Professional		$204.17	$234.42	$512.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $426.58	Facility		$204.17	$257.04	$426.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $269.15 / $436.52	Facility		$204.17	$269.15	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $204.17 / $263.03	Professional		$79.43	$204.17	$263.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $331.13 / $660.69	Facility		$199.53	$331.13	$660.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $234.42	Professional		$204.17	$204.17	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $489.78	Facility		$204.17	$204.17	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $204.17 / $234.42	Professional		$81.28	$204.17	$234.42