Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $238.71 / $395.66	Facility		$197.65	$238.71	$395.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $199.81 / $271.67	Professional		$197.83	$199.81	$271.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.63 / $329.20 / $388.16	Facility		$186.63	$329.20	$388.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $223.96	Professional		$197.83	$197.83	$223.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $313.27 / $433.32 / $517.44	Professional		$313.27	$433.32	$517.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $207.72 / $425.33	Facility		$197.65	$207.72	$425.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $209.70 / $257.18	Professional		$197.83	$209.70	$257.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.50 / $197.83 / $410.21	Facility		$190.50	$197.83	$410.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $197.83 / $210.32 / $412.36	Facility		$197.83	$210.32	$412.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $229.53 / $251.95	Professional		$197.83	$229.53	$251.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $180.64 / $270.95 / $670.67	Facility		$180.64	$270.95	$670.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $237.40	Professional		$197.83	$197.83	$237.40
United Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $227.50	Professional		$197.83	$197.83	$227.50