Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.65 / $97.45 / $188.19	Facility		$80.65	$97.45	$188.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.19 / $65.19 / $364.61	Professional		$65.19	$65.19	$364.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.23 / $176.94 / $240.67	Facility		$109.23	$176.94	$240.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.89 / $77.23 / $120.43	Professional		$38.89	$77.23	$120.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $164.07 / $177.02	Professional		$67.20	$164.07	$177.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.00 / $72.73 / $141.54	Facility		$46.00	$72.73	$141.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $80.65 / $135.19	Professional		$67.20	$80.65	$135.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $90.73 / $164.00	Facility		$67.20	$90.73	$164.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $81.31 / $176.94	Facility		$67.20	$81.31	$176.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $84.01 / $110.04	Professional		$67.20	$84.01	$110.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.06 / $207.45 / $277.67	Facility		$131.06	$207.45	$277.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.25 / $85.68 / $165.74	Professional		$60.25	$85.68	$165.74
United Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $38.42 / $94.95	Professional		$28.23	$38.42	$94.95