Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.94 / $196.94 / $343.65	Facility		$196.94	$196.94	$343.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.88 / $67.15 / $67.15	Professional		$56.88	$67.15	$67.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.38 / $128.38 / $229.53	Facility		$128.38	$128.38	$229.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $63.20 / $63.20	Professional		$63.20	$63.20	$63.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $173.29 / $207.65	Professional		$79.00	$173.29	$207.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $59.25 / $82.95 / $173.80	Facility		$59.25	$82.95	$173.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $86.90 / $110.60	Professional		$79.00	$86.90	$110.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $88.48 / $138.25	Facility		$79.00	$88.48	$138.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $71.09 / $100.33 / $191.73	Facility		$71.09	$100.33	$191.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $86.90 / $110.60	Professional		$86.90	$86.90	$110.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $240.40 / $310.14	Facility		$158.00	$240.40	$310.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $126.17 / $155.15 / $248.33	Professional		$126.17	$155.15	$248.33
United Facility/Professional Professional Modifier Low / Median / High Price $33.18 / $33.18 / $94.80	Professional		$33.18	$33.18	$94.80