Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.22 / $143.22 / $156.80	Facility		$143.22	$143.22	$156.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $51.41 / $156.80	Professional		$19.96	$51.41	$156.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $100.00 / $120.00	Facility		$50.00	$100.00	$120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $64.50 / $163.32	Professional		$30.40	$64.50	$163.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.07 / $138.54 / $158.65	Professional		$120.07	$138.54	$158.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $59.31 / $105.00	Facility		$29.63	$59.31	$105.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.76 / $78.64 / $142.15	Professional		$41.76	$78.64	$142.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.21 / $98.49 / $125.29	Facility		$40.21	$98.49	$125.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.13 / $59.54 / $127.87	Facility		$33.13	$59.54	$127.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $85.95 / $162.35	Professional		$39.22	$85.95	$162.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $90.20 / $145.51 / $244.37	Facility		$90.20	$145.51	$244.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $77.27 / $167.20	Professional		$66.95	$77.27	$167.20
United Facility/Professional Professional Modifier Low / Median / High Price $29.37 / $53.05 / $134.74	Professional		$29.37	$53.05	$134.74