Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Facility		$158.91	$158.91	$158.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $486.60	Professional		$158.91	$158.91	$486.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $209.78 / $297.52	Facility		$149.91	$209.78	$297.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $172.41	Professional		$158.91	$158.91	$172.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.19 / $335.78 / $389.80	Professional		$119.19	$335.78	$389.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $101.40 / $166.86 / $227.26	Facility		$101.40	$166.86	$227.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $168.45 / $198.65	Professional		$158.91	$168.45	$198.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $198.65 / $476.76	Facility		$158.91	$198.65	$476.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $140.87 / $185.30 / $297.52	Facility		$140.87	$185.30	$297.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $183.39 / $187.40	Professional		$158.91	$183.39	$187.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $230.99 / $426.14 / $577.62	Facility		$230.99	$426.14	$577.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $182.76	Professional		$158.91	$158.91	$182.76
United Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $182.76	Professional		$158.91	$158.91	$182.76