Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $323.59	Professional		$12.02	$12.02	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $177.83	Professional		$151.36	$169.82	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $95.50 / $758.58	Facility		$87.10	$95.50	$758.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $398.11 / $426.58	Facility		$281.84	$398.11	$426.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $758.58	Facility		$87.10	$100.00	$758.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $79.43	Professional		$70.79	$79.43	$79.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $56.23	Professional		$37.15	$43.65	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36