Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.53 / $140.97 / $272.22	Facility		$121.53	$140.97	$272.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $83.30 / $189.58	Professional		$70.00	$83.30	$189.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $157.97 / $243.28 / $293.38	Facility		$157.97	$243.28	$293.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.38 / $107.39 / $174.47	Professional		$85.38	$107.39	$174.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $213.78 / $256.17	Professional		$97.22	$213.78	$256.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.92 / $102.08 / $213.88	Facility		$72.92	$102.08	$213.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $97.22 / $131.25	Professional		$97.22	$97.22	$131.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $102.08 / $214.61	Facility		$97.22	$102.08	$214.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.08 / $122.98 / $243.28	Facility		$102.08	$122.98	$243.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.48 / $111.83 / $142.76	Professional		$103.48	$111.83	$142.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $189.58 / $295.83 / $381.68	Facility		$189.58	$295.83	$381.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $171.77 / $191.22 / $305.88	Professional		$171.77	$191.22	$305.88
United Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $40.83 / $97.22	Professional		$40.83	$40.83	$97.22