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 $89.13 / $112.20 / $181.97	Professional		$89.13	$112.20	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $407.38 / $501.19	Professional		$158.49	$407.38	$501.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $154.88 / $213.80	Facility		$123.03	$154.88	$213.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $162.18 / $218.78	Professional		$151.36	$162.18	$218.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $199.53 / $213.80	Facility		$162.18	$199.53	$213.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $213.80	Professional		$186.21	$204.17	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $257.04	Facility		$109.65	$169.82	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $177.83 / $213.80	Professional		$87.10	$177.83	$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 / $309.03 / $407.38	Facility		$93.33	$309.03	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $177.83	Professional		$85.11	$93.33	$177.83