Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $173.78 / $186.21	Facility		$91.20	$173.78	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $186.21	Professional		$64.57	$83.18	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $75.86 / $107.15	Facility		$50.12	$75.86	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $199.53	Professional		$77.62	$123.03	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $181.97	Professional		$109.65	$147.91	$181.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $91.20 / $173.78	Facility		$70.79	$91.20	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $177.83	Professional		$89.13	$128.82	$177.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $138.04 / $162.18	Facility		$112.20	$138.04	$162.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $97.72 / $177.83	Facility		$64.57	$97.72	$177.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $186.21	Professional		$79.43	$117.49	$186.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $186.21 / $295.12	Facility		$107.15	$186.21	$295.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $194.98	Professional		$74.13	$87.10	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $114.82	Facility		$77.62	$77.62	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $190.55	Professional		$77.62	$131.83	$190.55