Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.96 / $352.90 / $3,052.30	Facility		$170.96	$352.90	$3,052.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $522.87 / $1,900.80	Professional		$176.45	$522.87	$1,900.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.46 / $307.01 / $344.58	Facility		$166.46	$307.01	$344.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $206.37	Professional		$176.45	$176.45	$206.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.30 / $369.16 / $475.75	Professional		$260.30	$369.16	$475.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $237.84 / $596.23	Facility		$155.41	$237.84	$596.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $191.64 / $241.74	Professional		$176.45	$191.64	$241.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $199.75 / $529.35	Facility		$155.41	$199.75	$529.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $176.45 / $213.50 / $591.84	Facility		$176.45	$213.50	$591.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $211.81 / $244.07	Professional		$176.45	$211.81	$244.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $182.45 / $288.86 / $605.77	Facility		$182.45	$288.86	$605.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $194.10	Professional		$176.45	$176.45	$194.10
United Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $204.68	Professional		$176.45	$176.45	$204.68