Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.17 / $235.17 / $235.17	Facility		$235.17	$235.17	$235.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $237.75	Professional		$204.96	$204.96	$237.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.35 / $372.66 / $525.86	Facility		$193.35	$372.66	$525.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $251.36	Professional		$204.96	$204.96	$251.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $394.26 / $573.47 / $754.01	Professional		$394.26	$573.47	$754.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $235.17 / $1,075.04	Facility		$204.96	$235.17	$1,075.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $217.26 / $266.45	Professional		$204.96	$217.26	$266.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $258.69 / $614.88	Facility		$204.96	$258.69	$614.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $319.64 / $875.52	Facility		$204.96	$319.64	$875.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $329.19 / $495.52	Professional		$204.96	$329.19	$495.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.71 / $204.96 / $204.96	Professional		$194.71	$204.96	$204.96
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $235.70	Professional		$204.96	$204.96	$235.70