Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $295.54 / $497.00	Facility		$248.50	$295.54	$497.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $250.98 / $427.42	Professional		$248.50	$250.98	$427.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.43 / $413.17 / $487.26	Facility		$234.43	$413.17	$487.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $248.50 / $281.32	Professional		$248.50	$248.50	$281.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.48 / $545.21 / $666.76	Professional		$416.48	$545.21	$666.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $260.93 / $534.28	Facility		$248.50	$260.93	$534.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $263.41 / $323.05	Professional		$248.50	$263.41	$323.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $310.63 / $745.50	Facility		$248.50	$310.63	$745.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $248.50 / $284.18 / $498.95	Facility		$248.50	$284.18	$498.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $284.18 / $316.48	Professional		$248.50	$284.18	$316.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $216.25 / $366.14 / $828.01	Facility		$216.25	$366.14	$828.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $248.50 / $273.35	Professional		$248.50	$248.50	$273.35
United Facility/Professional Professional Modifier Low / Median / High Price $248.50 / $248.50 / $285.77	Professional		$248.50	$248.50	$285.77