Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.20 / $655.20 / $655.20	Facility		$655.20	$655.20	$655.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.70 / $88.18 / $418.34	Professional		$46.70	$88.18	$418.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.85 / $128.85 / $128.85	Facility		$128.85	$128.85	$128.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $109.52 / $128.85	Professional		$109.52	$109.52	$128.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $306.81 / $400.16	Professional		$101.49	$306.81	$400.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $88.18 / $120.81 / $148.50	Facility		$88.18	$120.81	$148.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.81 / $136.29 / $152.24	Professional		$107.81	$136.29	$152.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.09 / $141.59 / $159.49	Facility		$115.09	$141.59	$159.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $144.99 / $159.49	Professional		$137.74	$144.99	$159.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.17 / $124.52 / $144.99	Facility		$87.17	$124.52	$144.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $126.96 / $159.49	Professional		$109.52	$126.96	$159.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.80 / $241.12 / $508.68	Facility		$120.80	$241.12	$508.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $126.14 / $159.49 / $159.49	Professional		$126.14	$159.49	$159.49
United Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $72.34 / $138.00	Professional		$68.09	$72.34	$138.00