Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $600.00	Facility		$255.00	$255.00	$600.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.00 / $249.00 / $255.00	Professional		$249.00	$249.00	$255.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $510.00 / $510.00	Facility		$510.00	$510.00	$510.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.30 / $151.46 / $166.68	Professional		$131.30	$151.46	$166.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.91 / $221.52 / $356.07	Facility		$54.91	$221.52	$356.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.43 / $104.55 / $330.29	Professional		$60.43	$104.55	$330.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $318.72 / $79,999.20 / $79,999.20	Facility		$318.72	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $90.39 / $260.75 / $510.00	Facility		$90.39	$260.75	$510.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $135.04 / $259.13 / $312.50	Professional		$135.04	$259.13	$312.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $235.61 / $382.80 / $780.69	Facility		$235.61	$382.80	$780.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $242.25 / $255.00 / $255.00	Professional		$242.25	$255.00	$255.00
United Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $287.50	Professional		$250.00	$250.00	$287.50