Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $53.70 / $102.33	Professional		$30.20	$53.70	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $239.88 / $302.00	Facility		$47.86	$239.88	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $281.84	Professional		$102.33	$165.96	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $512.86	Professional		$213.80	$426.58	$512.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $107.15 / $239.88	Facility		$54.95	$107.15	$239.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $102.33	Professional		$32.36	$54.95	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $134.90 / $134.90	Facility		$89.13	$134.90	$134.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $112.20 / $309.03	Facility		$64.57	$112.20	$309.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $125.89 / $257.04	Professional		$70.79	$125.89	$257.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $281.84 / $354.81	Facility		$204.17	$281.84	$354.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $141.25 / $263.03	Professional		$64.57	$141.25	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $323.59 / $426.58	Facility		$263.03	$323.59	$426.58