Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $84.05 / $114.32	Professional		$67.12	$84.05	$114.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.62 / $149.62 / $170.48	Professional		$149.62	$149.62	$170.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.42 / $62.19 / $220.25	Professional		$54.42	$62.19	$220.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.34 / $120.04 / $163.52	Facility		$56.34	$120.04	$163.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $116.79 / $141.97 / $189.23	Professional		$116.79	$141.97	$189.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $108.53 / $147.40 / $156.11	Facility		$108.53	$147.40	$156.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.34 / $114.32 / $163.52	Facility		$56.34	$114.32	$163.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.31 / $149.04 / $176.00	Professional		$107.31	$149.04	$176.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.60 / $127.82 / $209.25	Professional		$127.60	$127.82	$209.25
United Facility/Professional Professional Modifier Low / Median / High Price $87.74 / $156.91 / $244.69	Professional		$87.74	$156.91	$244.69