Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $239.88 / $398.11	Facility		$162.18	$239.88	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $229.09	Professional		$162.18	$165.96	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $257.04 / $302.00	Facility		$154.88	$257.04	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $186.21	Professional		$162.18	$162.18	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $346.74 / $416.87	Professional		$177.83	$346.74	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $309.03	Facility		$162.18	$173.78	$309.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $229.09	Professional		$147.91	$173.78	$229.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $204.17 / $338.84	Facility		$165.96	$204.17	$338.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $165.96 / $295.12	Facility		$162.18	$165.96	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $208.93	Professional		$79.43	$162.18	$208.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $245.47 / $467.74	Facility		$128.82	$245.47	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $389.05	Facility		$162.18	$162.18	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97