Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $96.72 / $186.76	Facility		$80.04	$96.72	$186.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.70 / $64.70 / $361.79	Professional		$64.70	$64.70	$361.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.40 / $175.61 / $237.89	Facility		$108.40	$175.61	$237.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $76.41 / $119.84	Professional		$50.62	$76.41	$119.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $162.49 / $175.33	Professional		$66.70	$162.49	$175.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.76 / $72.17 / $168.50	Facility		$54.76	$72.17	$168.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $76.70 / $97.44	Professional		$66.70	$76.70	$97.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $80.04 / $147.24	Facility		$66.70	$80.04	$147.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $80.70 / $193.43	Facility		$66.70	$80.70	$193.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $80.04 / $109.20	Professional		$66.70	$80.04	$109.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $130.07 / $205.88 / $275.56	Facility		$130.07	$205.88	$275.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $85.03 / $164.10	Professional		$59.67	$85.03	$164.10
United Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $38.11 / $80.04	Professional		$28.01	$38.11	$80.04