Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $104.71 / $309.03	Facility		$85.11	$104.71	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $125.89	Professional		$38.02	$64.57	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $181.97 / $245.47	Facility		$112.20	$181.97	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $74.13 / $134.90	Professional		$45.71	$74.13	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $181.97	Professional		$69.18	$147.91	$181.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $128.82	Facility		$69.18	$69.18	$128.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $83.18 / $112.20	Professional		$69.18	$83.18	$112.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $128.82	Facility		$69.18	$69.18	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $107.15 / $204.17	Facility		$66.07	$107.15	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $83.18 / $112.20	Professional		$69.18	$83.18	$112.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $204.17 / $281.84	Facility		$102.33	$204.17	$281.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $83.18	Professional		$54.95	$58.88	$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 $40.74 / $56.23 / $138.04	Professional		$40.74	$56.23	$138.04