Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $147.91	Facility		$120.23	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $141.25	Professional		$48.98	$63.10	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $117.49 / $173.78	Professional		$63.10	$117.49	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $154.88	Professional		$104.71	$117.49	$154.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $74.13 / $125.89	Facility		$53.70	$74.13	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $165.96	Professional		$93.33	$120.23	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $123.03 / $128.82	Facility		$102.33	$123.03	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $79.43 / $138.04	Facility		$53.70	$79.43	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $173.78	Professional		$79.43	$131.83	$173.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $169.82	Professional		$102.33	$128.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $177.83	Professional		$75.86	$125.89	$177.83