Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $213.80 / $489.78	Facility		$95.50	$213.80	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $100.00	Professional		$44.67	$67.61	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $173.78 / $234.42	Facility		$107.15	$173.78	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $117.49	Professional		$50.12	$72.44	$117.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $141.25 / $173.78	Professional		$66.07	$141.25	$173.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $218.78	Facility		$66.07	$66.07	$218.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $93.33	Professional		$66.07	$72.44	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $123.03	Facility		$66.07	$66.07	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $91.20 / $194.98	Facility		$58.88	$91.20	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $102.33	Professional		$66.07	$79.43	$102.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $194.98 / $269.15	Facility		$97.72	$194.98	$269.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $54.95 / $77.62	Professional		$52.48	$54.95	$77.62
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $104.71	Facility		$77.62	$77.62	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $37.15 / $77.62	Professional		$27.54	$37.15	$77.62