Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $177.83	Professional		$83.18	$114.82	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $416.87 / $512.86	Professional		$158.49	$416.87	$512.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $154.88 / $229.09	Facility		$123.03	$154.88	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $165.96 / $223.87	Professional		$154.88	$165.96	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $190.55 / $204.17	Facility		$162.18	$190.55	$204.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $204.17	Professional		$186.21	$204.17	$204.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $173.78 / $269.15	Facility		$102.33	$173.78	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $181.97 / $213.80	Professional		$87.10	$181.97	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $288.40 / $794.33	Facility		$169.82	$288.40	$794.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $229.09 / $229.09	Professional		$208.93	$229.09	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $123.03 / $416.87	Facility		$93.33	$123.03	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $181.97	Professional		$85.11	$95.50	$181.97