Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $107.15 / $309.03	Facility		$87.10	$107.15	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $107.15	Professional		$36.31	$52.48	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $181.97 / $208.93	Facility		$112.20	$181.97	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $100.00 / $123.03	Professional		$43.65	$100.00	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $177.83	Professional		$69.18	$147.91	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $93.33	Professional		$69.18	$75.86	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $131.83	Facility		$69.18	$69.18	$131.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $95.50 / $204.17	Facility		$67.61	$95.50	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $107.15	Professional		$69.18	$77.62	$107.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $204.17 / $275.42	Facility		$102.33	$204.17	$275.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $83.18	Professional		$51.29	$63.10	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $109.65	Facility		$83.18	$83.18	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $83.18	Professional		$28.84	$33.88	$83.18