Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $91.20	Professional		$57.54	$67.61	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $194.98	Professional		$75.86	$138.04	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $177.83	Professional		$104.71	$138.04	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $83.18 / $138.04	Facility		$63.10	$83.18	$138.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $93.33	Professional		$60.26	$70.79	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $134.90 / $138.04	Facility		$112.20	$134.90	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $79.43 / $131.83	Facility		$60.26	$79.43	$131.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $181.97	Professional		$70.79	$79.43	$181.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $177.83	Professional		$95.50	$138.04	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $120.23 / $194.98	Professional		$69.18	$120.23	$194.98