Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $257.04	Professional		$112.20	$158.49	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $562.34 / $691.83	Professional		$199.53	$562.34	$691.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $194.98 / $309.03	Facility		$158.49	$194.98	$309.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $281.84	Professional		$190.55	$204.17	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $251.19 / $257.04	Facility		$204.17	$251.19	$257.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $257.04 / $257.04	Professional		$234.42	$257.04	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $223.87 / $363.08	Facility		$131.83	$223.87	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $229.09 / $275.42	Professional		$87.10	$229.09	$275.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $363.08 / $1,000.00	Facility		$213.80	$363.08	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $288.40 / $288.40	Professional		$263.03	$288.40	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $173.78 / $562.34	Facility		$104.71	$173.78	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $245.47	Professional		$117.49	$128.82	$245.47