Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.45 / $174.45 / $194.18	Facility		$174.45	$174.45	$194.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.52 / $73.81 / $214.19	Professional		$33.52	$73.81	$214.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.44 / $138.99 / $218.61	Professional		$54.44	$138.99	$218.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $155.93 / $194.05	Professional		$123.65	$155.93	$194.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.44 / $102.10 / $205.99	Facility		$81.44	$102.10	$205.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.26 / $129.06 / $241.90	Professional		$107.26	$129.06	$241.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.86 / $126.63 / $155.44	Facility		$55.86	$126.63	$155.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.49 / $103.47 / $199.94	Facility		$85.49	$103.47	$199.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $149.69 / $214.44	Professional		$68.04	$149.69	$214.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.05 / $157.88 / $248.33	Professional		$91.05	$157.88	$248.33
United Facility/Professional Facility Modifier Low / Median / High Price $78.84 / $78.84 / $78.84	Facility		$78.84	$78.84	$78.84
United Facility/Professional Professional Modifier Low / Median / High Price $55.85 / $117.65 / $202.27	Professional		$55.85	$117.65	$202.27