Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.85 / $130.85 / $174.46	Facility		$130.85	$130.85	$174.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $100.62 / $174.46	Professional		$75.41	$100.62	$174.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.35 / $169.35 / $169.35	Facility		$169.35	$169.35	$169.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $112.44 / $249.61	Professional		$72.00	$112.44	$249.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.62 / $196.53 / $251.94	Professional		$139.62	$196.53	$251.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $88.91 / $141.88 / $212.63	Facility		$88.91	$141.88	$212.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $110.67 / $162.79 / $241.86	Professional		$110.67	$162.79	$241.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $182.68 / $196.31	Facility		$120.00	$182.68	$196.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.71 / $137.66 / $226.80	Facility		$89.71	$137.66	$226.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $151.83 / $245.39	Professional		$89.18	$151.83	$245.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.12 / $77.12 / $77.12	Facility		$77.12	$77.12	$77.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $141.79 / $240.41	Professional		$100.91	$141.79	$240.41
United Facility/Professional Professional Modifier Low / Median / High Price $88.21 / $137.76 / $255.43	Professional		$88.21	$137.76	$255.43