Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $120.23 / $354.81	Facility		$97.72	$120.23	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $120.23	Professional		$53.70	$75.86	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $204.17 / $269.15	Facility		$125.89	$204.17	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $141.25	Professional		$57.54	$77.62	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $169.82 / $199.53	Professional		$77.62	$169.82	$199.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $109.65	Facility		$77.62	$77.62	$109.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $131.83	Professional		$77.62	$104.71	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $147.91	Facility		$77.62	$77.62	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $112.20 / $269.15	Facility		$75.86	$112.20	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $141.25	Professional		$77.62	$87.10	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $234.42 / $323.59	Facility		$117.49	$234.42	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $100.00	Professional		$58.88	$77.62	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $125.89	Facility		$93.33	$93.33	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $109.65	Professional		$33.11	$44.67	$109.65