Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $416.87	Facility		$173.78	$251.19	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $288.40	Professional		$173.78	$173.78	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $281.84 / $331.13	Facility		$162.18	$281.84	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $194.98	Professional		$173.78	$173.78	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $363.08 / $446.68	Professional		$173.78	$363.08	$446.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $186.21 / $316.23	Facility		$154.88	$186.21	$316.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $269.15	Professional		$158.49	$181.97	$269.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $218.78 / $363.08	Facility		$173.78	$218.78	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $173.78 / $288.40	Facility		$123.03	$173.78	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $173.78 / $218.78	Professional		$79.43	$173.78	$218.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $275.42 / $489.78	Facility		$138.04	$275.42	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $245.47	Professional		$165.96	$173.78	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $416.87	Facility		$173.78	$173.78	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $199.53	Professional		$173.78	$173.78	$199.53