Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.85 / $164.88 / $319.60	Facility		$93.85	$164.88	$319.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $52.83 / $70.02	Professional		$51.98	$52.83	$70.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.30 / $180.64 / $209.73	Facility		$117.30	$180.64	$209.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $75.89 / $129.24	Professional		$35.52	$75.89	$129.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.19 / $175.90 / $189.78	Professional		$72.19	$175.90	$189.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.92 / $72.19 / $150.54	Facility		$46.92	$72.19	$150.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.19 / $72.19 / $98.18	Professional		$72.19	$72.19	$98.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.19 / $75.80 / $136.66	Facility		$72.19	$75.80	$136.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $86.63 / $180.64	Facility		$52.57	$86.63	$180.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.58 / $79.41 / $101.07	Professional		$68.58	$79.41	$101.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $140.77 / $219.67 / $298.25	Facility		$140.77	$219.67	$298.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $110.95 / $178.05	Professional		$64.59	$110.95	$178.05
United Facility/Professional Professional Modifier Low / Median / High Price $30.32 / $30.32 / $86.63	Professional		$30.32	$30.32	$86.63