Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $218.56 / $936.72	Facility		$109.28	$218.56	$936.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $112.85 / $1,188.83	Professional		$108.47	$112.85	$1,188.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $231.03 / $300.82	Facility		$102.33	$231.03	$300.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $137.35	Professional		$108.47	$108.47	$137.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.00 / $246.98 / $358.31	Professional		$178.00	$246.98	$358.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $131.24 / $343.94	Facility		$108.47	$131.24	$343.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $124.74 / $141.01	Professional		$108.47	$124.74	$141.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $124.84 / $327.84	Facility		$108.47	$124.84	$327.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $166.08 / $343.94	Facility		$108.47	$166.08	$343.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.68 / $170.06 / $198.44	Professional		$117.68	$170.06	$198.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $217.97 / $819.68	Facility		$136.22	$217.97	$819.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $108.47	Professional		$108.47	$108.47	$108.47
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $125.83	Professional		$108.47	$108.47	$125.83