Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.15 / $132.72 / $163.15	Professional		$76.15	$132.72	$163.15
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 $133.56 / $240.34 / $450.19	Professional		$133.56	$240.34	$450.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.24 / $370.03 / $419.19	Professional		$317.24	$370.03	$419.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.98 / $163.75 / $327.25	Facility		$104.98	$163.75	$327.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $265.39 / $265.39 / $265.39	Professional		$265.39	$265.39	$265.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $200.60 / $307.98 / $334.33	Facility		$200.60	$307.98	$334.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $163.75 / $327.25	Facility		$100.00	$163.75	$327.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $155.81 / $270.14 / $451.90	Professional		$155.81	$270.14	$451.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $284.10 / $451.20 / $652.09	Facility		$284.10	$451.20	$652.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $178.64 / $204.16 / $456.32	Professional		$178.64	$204.16	$456.32
United Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $167.09 / $394.23	Professional		$134.97	$167.09	$394.23