Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $158.49 / $199.53	Facility		$72.44	$158.49	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $114.82 / $199.53	Professional		$57.54	$114.82	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $234.42	Professional		$95.50	$151.36	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $177.83	Professional		$114.82	$147.91	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $134.90 / $229.09	Facility		$72.44	$134.90	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $223.87	Professional		$77.62	$131.83	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $141.25	Facility		$104.71	$138.04	$141.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $117.49 / $199.53	Facility		$69.18	$117.49	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $144.54 / $199.53	Professional		$79.43	$144.54	$199.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $190.55 / $288.40	Facility		$104.71	$190.55	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $218.78	Professional		$89.13	$134.90	$218.78