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 $158.49 / $158.49 / $199.53	Professional		$158.49	$158.49	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $295.12	Facility		$151.36	$208.93	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $173.78	Professional		$151.36	$158.49	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $398.11	Professional		$112.20	$169.82	$398.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $169.82 / $199.53	Facility		$158.49	$169.82	$199.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $208.93	Professional		$158.49	$173.78	$208.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $199.53 / $331.13	Facility		$158.49	$199.53	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $186.21 / $295.12	Facility		$151.36	$186.21	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $151.36 / $186.21	Professional		$79.43	$151.36	$186.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $363.08 / $588.84	Facility		$218.78	$363.08	$588.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $181.97	Professional		$158.49	$158.49	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $158.49 / $181.97	Professional		$63.10	$158.49	$181.97