Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.55 / $356.55 / $356.55	Facility		$356.55	$356.55	$356.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $349.02 / $404.86	Professional		$349.02	$349.02	$404.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.26 / $329.26 / $721.02	Facility		$329.26	$329.26	$721.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.01 / $349.01 / $411.57	Professional		$349.01	$349.01	$411.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $351.47 / $782.66 / $906.63	Professional		$351.47	$782.66	$906.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $356.55 / $891.00	Facility		$349.02	$356.55	$891.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $383.92 / $453.73	Professional		$349.02	$383.92	$453.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.01 / $356.55 / $724.37	Facility		$349.01	$356.55	$724.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $429.39 / $891.00	Facility		$349.02	$429.39	$891.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $349.01 / $500.00 / $1,187.48	Professional		$349.01	$500.00	$1,187.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.57 / $349.02 / $349.02	Professional		$331.57	$349.02	$349.02
United Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $349.02 / $401.37	Professional		$349.02	$349.02	$401.37