Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $309.03 / $512.86	Facility		$213.80	$309.03	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $295.12	Professional		$213.80	$213.80	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $295.12 / $416.87	Facility		$199.53	$295.12	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $234.42	Professional		$213.80	$213.80	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $457.09 / $549.54	Professional		$213.80	$457.09	$549.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $229.09 / $426.58	Facility		$213.80	$229.09	$426.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $275.42	Professional		$213.80	$229.09	$275.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $269.15 / $446.68	Facility		$213.80	$269.15	$446.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $295.12 / $616.60	Facility		$213.80	$295.12	$616.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $213.80 / $251.19	Professional		$79.43	$213.80	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $331.13 / $676.08	Facility		$204.17	$331.13	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $512.86	Facility		$213.80	$213.80	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80