Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $162.18	Professional		$72.44	$85.11	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $102.33	Professional		$52.48	$61.66	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $269.15 / $331.13	Professional		$104.71	$269.15	$331.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $83.18 / $114.82	Facility		$12.30	$83.18	$114.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $154.88	Professional		$109.65	$120.23	$154.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $144.54	Facility		$141.25	$141.25	$144.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $100.00 / $147.91	Facility		$61.66	$100.00	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $162.18	Professional		$52.48	$61.66	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $208.93 / $478.63	Facility		$141.25	$208.93	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $72.44 / $97.72	Facility		$10.72	$72.44	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $117.49	Professional		$57.54	$61.66	$117.49