Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $288.40 / $512.86	Facility		$112.20	$288.40	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $138.04	Professional		$75.86	$85.11	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $295.12 / $331.13	Facility		$186.21	$295.12	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $165.96	Professional		$67.61	$114.82	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $245.47 / $295.12	Professional		$114.82	$245.47	$295.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $158.49	Facility		$114.82	$114.82	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $165.96	Professional		$114.82	$131.83	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $125.89 / $199.53	Facility		$102.33	$125.89	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $158.49 / $331.13	Facility		$112.20	$158.49	$331.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $144.54	Professional		$79.43	$114.82	$144.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $338.84 / $446.68	Facility		$169.82	$338.84	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $138.04	Professional		$85.11	$104.71	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $181.97	Facility		$138.04	$138.04	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $138.04	Professional		$47.86	$47.86	$138.04