Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $125.89 / $302.00	Facility		$85.11	$125.89	$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 $44.67 / $67.61 / $120.23	Professional		$44.67	$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 / $93.33	Facility		$67.61	$67.61	$93.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $109.65	Professional		$67.61	$81.28	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $128.82	Facility		$67.61	$67.61	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $97.72 / $204.17	Facility		$66.07	$97.72	$204.17
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 / $204.17 / $275.42	Facility		$100.00	$204.17	$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 / $38.90 / $93.33	Professional		$28.18	$38.90	$93.33