Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $102.33 / $302.00	Facility		$83.18	$102.33	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $102.33	Professional		$45.71	$64.57	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $173.78 / $239.88	Facility		$109.65	$173.78	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $120.23	Professional		$46.77	$66.07	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $144.54 / $169.82	Professional		$66.07	$144.54	$169.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $109.65	Professional		$66.07	$79.43	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $125.89	Facility		$66.07	$66.07	$125.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $95.50 / $204.17	Facility		$64.57	$95.50	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $120.23	Professional		$66.07	$79.43	$120.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $199.53 / $275.42	Facility		$100.00	$199.53	$275.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $85.11	Professional		$50.12	$66.07	$85.11
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $107.15	Facility		$79.43	$79.43	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $93.33	Professional		$28.18	$38.02	$93.33