Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $151.36 / $363.08	Facility		$100.00	$151.36	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $61.66 / $154.88	Professional		$7.08	$61.66	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $234.42	Facility		$131.83	$131.83	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $81.28 / $144.54	Professional		$5.75	$81.28	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $173.78 / $204.17	Professional		$81.28	$173.78	$204.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $81.28 / $104.71	Facility		$77.62	$81.28	$104.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $81.28 / $109.65	Professional		$11.75	$81.28	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $151.36	Facility		$81.28	$81.28	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $112.20 / $239.88	Facility		$13.18	$112.20	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $81.28 / $112.20	Professional		$11.75	$81.28	$112.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $234.42 / $316.23	Facility		$120.23	$234.42	$316.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $67.61 / $95.50	Professional		$8.71	$67.61	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $128.82	Facility		$95.50	$95.50	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $33.88 / $95.50	Professional		$4.90	$33.88	$95.50