Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $177.83	Facility		$109.65	$162.18	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $165.96	Professional		$53.70	$77.62	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $204.17	Professional		$114.82	$177.83	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $158.49 / $181.97	Professional		$81.28	$158.49	$181.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $151.36 / $234.42	Facility		$93.33	$151.36	$234.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $208.93	Professional		$109.65	$151.36	$208.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $131.83 / $144.54	Facility		$109.65	$131.83	$144.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $154.88 / $245.47	Facility		$109.65	$154.88	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $194.98	Professional		$104.71	$147.91	$194.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $177.83	Professional		$123.03	$151.36	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $70.79 / $223.87	Professional		$66.07	$70.79	$223.87