Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.11 / $92.13 / $105.48	Facility		$79.11	$92.13	$105.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $77.48 / $112.89	Professional		$58.90	$77.48	$112.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.78 / $109.78 / $109.78	Facility		$109.78	$109.78	$109.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $86.00 / $187.21	Professional		$62.00	$86.00	$187.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.12 / $138.66 / $178.33	Professional		$98.12	$138.66	$178.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.77 / $92.57 / $166.83	Facility		$64.77	$92.57	$166.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.51 / $127.37 / $201.30	Professional		$81.51	$127.37	$201.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.36 / $149.32 / $160.13	Facility		$95.36	$149.32	$160.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.88 / $92.57 / $170.85	Facility		$64.88	$92.57	$170.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.11 / $116.08 / $188.80	Professional		$70.11	$116.08	$188.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $131.97 / $184.61	Professional		$89.03	$131.97	$184.61
United Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $136.27 / $219.87	Professional		$80.20	$136.27	$219.87