Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.85 / $109.85 / $109.85	Facility		$109.85	$109.85	$109.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.16 / $67.16 / $386.52	Professional		$67.16	$67.16	$386.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.16 / $88.16 / $88.16	Facility		$88.16	$88.16	$88.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $88.16 / $102.18	Professional		$74.94	$88.16	$102.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.94 / $115.64 / $352.16	Professional		$89.94	$115.64	$352.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.16 / $137.88 / $158.15	Facility		$67.16	$137.88	$158.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $118.59 / $150.24	Professional		$15.05	$118.59	$150.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.49 / $137.88 / $161.27	Facility		$128.49	$137.88	$161.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.63 / $134.38 / $152.28	Professional		$125.63	$134.38	$152.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.16 / $131.31 / $183.37	Facility		$67.16	$131.31	$183.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $117.87 / $148.29	Professional		$88.16	$117.87	$148.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $189.40 / $189.40 / $222.78	Facility		$189.40	$189.40	$222.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.46 / $128.46 / $128.46	Professional		$128.46	$128.46	$128.46
United Facility/Professional Professional Modifier Low / Median / High Price $65.86 / $65.86 / $126.58	Professional		$65.86	$65.86	$126.58