Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.01 / $160.01 / $279.23	Facility		$160.01	$160.01	$279.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $62.26 / $62.26	Professional		$46.22	$62.26	$62.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.30 / $160.62 / $186.49	Facility		$104.30	$160.62	$186.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.17 / $73.51 / $91.89	Professional		$64.17	$73.51	$91.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.19 / $156.18 / $168.51	Professional		$64.19	$156.18	$168.51
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.36 / $64.19 / $133.86	Facility		$33.36	$64.19	$133.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.19 / $64.19 / $86.66	Professional		$64.19	$64.19	$86.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.19 / $67.40 / $89.87	Facility		$64.19	$67.40	$89.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.36 / $73.81 / $160.62	Facility		$33.36	$73.81	$160.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.98 / $70.61 / $89.87	Professional		$60.98	$70.61	$89.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.17 / $195.33 / $251.99	Facility		$125.17	$195.33	$251.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.35 / $76.47 / $158.36	Professional		$57.35	$76.47	$158.36
United Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $26.96 / $77.03	Professional		$26.96	$26.96	$77.03