Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $302.00	Facility		$83.18	$104.71	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $104.71	Professional		$46.77	$64.57	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $177.83 / $239.88	Facility		$109.65	$177.83	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $67.61 / $120.23	Professional		$35.48	$67.61	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $144.54 / $173.78	Professional		$67.61	$144.54	$173.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $85.11	Facility		$67.61	$67.61	$85.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $134.90	Professional		$67.61	$83.18	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $147.91	Facility		$67.61	$67.61	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $97.72 / $199.53	Facility		$64.57	$97.72	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $120.23	Professional		$67.61	$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 / $67.61 / $85.11	Professional		$50.12	$67.61	$85.11
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $107.15	Facility		$81.28	$81.28	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $93.33	Professional		$28.18	$38.02	$93.33