Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $237.04 / $31,855.20	Facility		$136.22	$237.04	$31,855.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $140.77 / $187.68	Professional		$136.66	$140.77	$187.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $225.70 / $265.45	Facility		$128.93	$225.70	$265.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $154.72	Professional		$136.66	$136.66	$154.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $215.85 / $297.33 / $356.53	Professional		$215.85	$297.33	$356.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $143.50 / $293.83	Facility		$136.22	$143.50	$293.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $144.87 / $177.67	Professional		$136.66	$144.87	$177.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $157.29 / $410.01	Facility		$136.22	$157.29	$410.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $151.54 / $276.25	Facility		$136.66	$151.54	$276.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $151.54 / $173.38	Professional		$136.66	$151.54	$173.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.81 / $176.72 / $442.84	Facility		$117.81	$176.72	$442.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $164.00	Professional		$136.66	$136.66	$164.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $158.54	Professional		$136.66	$136.66	$158.54