Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.46 / $133.41 / $159.49	Facility		$107.46	$133.41	$159.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.60 / $73.97 / $185.17	Professional		$60.60	$73.97	$185.17
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $209.60 / $215.25 / $245.55	Professional	25	$209.60	$215.25	$245.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $94.80 / $94.80	Facility		$94.80	$94.80	$94.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.90 / $146.69 / $207.49	Professional		$89.90	$146.69	$207.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $151.96 / $183.24	Professional		$129.72	$151.96	$183.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $95.58 / $178.50	Facility		$67.45	$95.58	$178.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $130.91 / $215.52	Professional		$113.14	$130.91	$215.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $93.72 / $135.34 / $142.71	Facility		$93.72	$135.34	$142.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $107.54 / $181.92	Facility		$67.45	$107.54	$181.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.01 / $156.13 / $197.51	Professional		$128.01	$156.13	$197.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.26 / $157.66 / $200.87	Professional		$117.26	$157.66	$200.87
United Facility/Professional Professional Modifier Low / Median / High Price $103.39 / $145.59 / $219.63	Professional		$103.39	$145.59	$219.63