Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $77.62	Facility		$72.44	$72.44	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $102.33	Professional		$72.44	$72.44	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $158.49 / $190.55	Professional		$74.13	$158.49	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $93.33	Facility		$74.13	$77.62	$93.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $93.33	Professional		$72.44	$77.62	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $128.82	Facility		$74.13	$74.13	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $104.71 / $218.78	Facility		$74.13	$104.71	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $72.44 / $87.10	Professional		$70.79	$72.44	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $239.88 / $295.12	Facility		$109.65	$239.88	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $89.13	Professional		$77.62	$83.18	$89.13