Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.26 / $194.26 / $194.26	Facility		$194.26	$194.26	$194.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $111.84 / $425.00	Professional		$73.45	$111.84	$425.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.81 / $120.81 / $120.81	Facility		$120.81	$120.81	$120.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $88.19 / $120.81	Professional		$88.19	$88.19	$120.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.50 / $361.50 / $471.48	Professional		$130.50	$361.50	$471.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $111.84 / $159.93 / $191.04	Facility		$111.84	$159.93	$191.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.13 / $177.11 / $195.75	Professional		$141.13	$177.11	$195.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $182.06 / $186.43 / $212.43	Facility		$182.06	$186.43	$212.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $148.12 / $148.12 / $148.12	Professional		$148.12	$148.12	$148.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.84 / $163.25 / $195.75	Facility		$111.84	$163.25	$195.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $163.25 / $205.07	Professional		$88.19	$163.25	$205.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $155.33 / $310.04 / $654.08	Facility		$155.33	$310.04	$654.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $160.33 / $205.07 / $205.07	Professional		$160.33	$205.07	$205.07
United Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $85.13 / $162.41	Professional		$81.34	$85.13	$162.41