Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $112.20 / $295.12	Facility		$75.86	$112.20	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $97.72 / $128.82	Professional		$64.57	$97.72	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $213.80 / $245.47	Professional		$97.72	$213.80	$245.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $104.71 / $138.04	Facility		$97.72	$104.71	$138.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $131.83	Professional		$74.13	$97.72	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $104.71 / $186.21	Facility		$74.13	$104.71	$186.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $141.25 / $245.47	Facility		$75.86	$141.25	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $107.15	Professional		$70.79	$81.28	$107.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $144.54 / $288.40	Facility		$95.50	$144.54	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $102.33	Professional		$97.72	$102.33	$102.33